摘要
脂蛋白(a)[Lp(a)]是温和独立的可预测冠状动脉心脏病(CHD)发病率和严重程度。几种已知和新出现的心血管(CV)危险因素,包括年龄,性别,种族,吸烟,血脂异常,高血压,肥胖,2型糖尿病,酒精消耗,动脉硬化和高尿酸血症已经与Lp(a)代谢相关。 除了CHD,Lp(a)也与非心脏血管疾病和CV风险增加相关的疾病有关,如慢性肾脏疾病,代谢综合征,非酒精性脂肪性肝病,勃起功能障碍,阻塞性睡眠呼吸暂停综合征,炎症肠病和人体免疫缺陷病毒感染。上述数据在本综述中进行了讨论。 几个指南表明Lp(a)在(重新)定义血管风险中的临床应用,特别是在中度或高CV风险的无症状个体以及具有早产儿CHD家族史的临床应用中。 通过改善个人风险分层,Lp(a)可能有助于更好的二级预防策略。 然而,仍然需要建立一种标准化的方法来测量Lp(a)以及降低Lp(a)的选择性有效治疗方法。 这将支持进行大量随机试验,以确定降低循环Lp(a)水平是否会导致CV事件显着减少。
关键词: 脂蛋白(a),心血管风险,血管危险因素,心脏病,非心脏血管疾病。
Current Medicinal Chemistry
Title:Lipoprotein (a) and Cardiovascular Risk: The Show Must go on
Volume: 24 Issue: 10
关键词: 脂蛋白(a),心血管风险,血管危险因素,心脏病,非心脏血管疾病。
摘要: Lipoprotein (a) [Lp(a)] is an independent but moderate, predictor for coronary heart disease (CHD) prevalence and severity. Several established and emerging cardiovascular (CV) risk factors including age, gender, ethnicity, smoking, dyslipidemia, hypertension, obesity, type 2 diabetes mellitus, alcohol consumption, arterial stiffness and hyperuricemia have been linked to Lp(a) metabolism. Apart from CHD, Lp(a) has been also associated with non-cardiac vascular diseases and diseases associated with increased CV risk such as chronic kidney disease, metabolic syndrome, non-alcoholic fatty liver disease, erectile dysfunction, obstructive sleep apnea syndrome, inflammatory bowel diseases and human immunodeficiency virus infection. The above data are discussed in the present narrative review.
Several guidelines suggest the clinical use of Lp(a) in (re)defining vascular risk, especially in asymptomatic individuals at intermediate or high CV risk and those with a family history of premature CHD. By improving individuals risk stratification, Lp(a) may contribute to a better secondary prevention strategy. However, there is still a need to establish a standardized method to measure Lp(a) as well as selective potent therapies for lowering Lp(a). This will support conducting large randomized trials in order to establish whether lowering circulating Lp(a) levels will result in a significant reduction in CV events.Export Options
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Cite this article as:
Lipoprotein (a) and Cardiovascular Risk: The Show Must go on, Current Medicinal Chemistry 2017; 24 (10) . https://dx.doi.org/10.2174/0929867324666170112111948
DOI https://dx.doi.org/10.2174/0929867324666170112111948 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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