Clínica e Investigación en Arteriosclerosis (English Edition)最新文献_第4页

The importance of early diagnosis and multidisciplinary intervention in the prevention of cardiovascular complications in people with diabesity 早期诊断和多学科干预对预防糖尿病患者心血管并发症的重要性

Clínica e Investigación en Arteriosclerosis (English Edition)

Pub Date : 2025-09-01 Epub Date: 2025-09-26 DOI: 10.1016/j.artere.2025.500857

Carlos Morillas Ariño

引用次数: 0

Efficacy and safety of PCSK9 inhibitors in real life PCSK9抑制剂在现实生活中的有效性和安全性

Clínica e Investigación en Arteriosclerosis (English Edition)

Pub Date : 2025-09-01 Epub Date: 2025-05-08 DOI: 10.1016/j.artere.2025.500755

Antón González-Guerrero , Eugenia Navarrete-Rouco , David Benaiges , Eva Giralt-Steinhauer , Lidia Marcos , Anna Oliveras , Lluis Recasens , Juan Pedro-Botet

Objective

To confirm the effectiveness and safety of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in daily clinical practice.

Methods

Retrospective observational study of patients from hospital registry of PCSK9 inhibitor treatment with a follow-up ≥ 6 mo. The lipid-lowering effect and safety were evaluated.

Results

Of the 193 patients included in the study, 168 (87%) had cardiovascular disease, and 54 (28%) had familial hypercholesterolemia; 85 (44%) were intolerant to statins/ezetimibe. No differences between alirocumab and evolocumab groups regarding the rate of LDL-C reduction ≥ 50% (82.8% vs. 83.1%), achievement of the therapeutic target (60.9% vs. 65.5%), or complete remission (60.2% vs. 58.5%) were found. An erythema at the injection site in one patient treated with alirocumab and urticaria in one patient treated with evolocumab were recorded. According to the logistic regression analysis, complete remission of LDL-C in subjects treated with PCSK9 inhibitors was positively associated with increased age (OR 1.045; 95% CI 1.0–1.092; p = 0.049) and active smoking (OR 4.562; 95% CI 1.434–14.515; p = 0.010), and negatively associated with female gender (OR 0.403; 95% CI 0.171–0.949; p = 0.038), baseline LDL-C levels (OR 0.969; 95% CI: 0.957–0.981; p < 0.001)and statin/ezetimibe intolerance (OR 0.403; 95% CI 0.176–0.925; p = 0.041).

Conclusion

This real-world practice study has confirmed that PCSK9 inhibitors are effective, safe and well tolerated, with lipid-lowering effects comparable to those described in randomized controlled trials, regardless of the monoclonal antibody used.

目的验证枯草杆菌蛋白转化酶9型（PCSK9）抑制剂在临床应用中的有效性和安全性。方法回顾性观察医院登记的PCSK9抑制剂治疗患者，随访≥6个月，评价其降脂效果和安全性。结果纳入研究的193例患者中，168例（87%）患有心血管疾病，54例（28%）患有家族性高胆固醇血症；85例（44%）对他汀类药物/依折麦布不耐受。alirocumab组和evolocumab组在LDL-C降低率≥50% （82.8% vs. 83.1%）、达到治疗目标（60.9% vs. 65.5%）或完全缓解（60.2% vs. 58.5%）方面无差异。一名接受alirocumab治疗的患者在注射部位出现红斑，一名接受evolocumab治疗的患者出现荨麻疹。根据logistic回归分析，接受PCSK9抑制剂治疗的受试者LDL-C完全缓解与年龄增加（OR 1.045; 95% CI 1.0-1.092; p = 0.049）和积极吸烟（OR 4.562; 95% CI 1.434-14.515; p = 0.010）呈正相关，与女性（OR 0.403; 95% CI 0.171-0.949; p = 0.038）、基线LDL-C水平（OR 0.969; 95% CI: 0.957-0.981; p < 0.001）和他汀类药物/依zetimibe不耐受（OR 0.403; 95% CI 0.175 - 0.925; p = 0.041）负相关。结论：无论使用何种单克隆抗体，PCSK9抑制剂都是有效、安全且耐受性良好的，其降脂效果与随机对照试验相当。

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引用次数: 0

Diabesity and cardiovascular mortality in a prospective population cohort followed for more than 20 years 糖尿病和心血管死亡率的前瞻性人群队列随访超过20年

Clínica e Investigación en Arteriosclerosis (English Edition)

Pub Date : 2025-09-01 Epub Date: 2025-05-05 DOI: 10.1016/j.artere.2025.500768

Julio A. Carbayo-Herencia , Marta Simarro Rueda , Luis Miguel Artigao Ródenas , Juan A. Divisón Garrote , Francisca Molina Escribano , Isabel Ponce García , Antonio Palazón Bru , Pilar Torres Moreno , David Caldevilla Bernardo , Rosalina Martínez López , Vicente Francisco Gil Guillén , José R. Banegas , on behalf of the Albacete Vascular Diseases Group (GEVA)

Introduction

Control of the main cardiovascular risk factors had succeeded in reducing cardiovascular diseases (CVD). However, the general increase in the prevalence of type 2 diabetes mellitus (DM2) and obesity has slowed this decline. Both CVRFs are strongly associated, and the term diabesity has been coined to refer to this relationship. The main objective of this study was to assess the influence of diabesity on cardiovascular mortality.

Methods

Prospective cohort study involving 1246 individuals (54.3% women) followed for 20.9 years (SD = 7.31) and selected by random two-stage sampling in a province in southeastern Spain. Diabesity was defined as the combination of DM2 with overweight and obesity. Survival curves (Kaplan-Meier) were calculated and two Cox regression models were used, one unadjusted and the other adjusted by the main explanatory variables in which the diabesity variable consisted of 6 categories (normal weight, overweight, obesity, normal weight + DM2, overweight + DM2 and obesity + DM2).

Results

There were 95 deaths due to CV causes (7.6% of the total; 6.2% women and 9.3% men; P = .01). After adjustment, the combination of DM2 and overweight increased the incidence of cardiovascular mortality by 133% (HR = 2.33; 95% CI: 1.18-4.58; P = .014) and the combination of DM2 and obesity by 49% (HR = 1.49; 95% CI: 0.64−3.45; P = .351), not reaching statistical significance in the latter case.

Conclusions

In the general population, the results of our study show that the combination of overweight and DM2 is associated with higher CV mortality. It seems a priority to intervene intensively in the control of both overweight and DM2.

前言控制主要心血管危险因素已成功减少心血管疾病。然而，2型糖尿病（DM2）和肥胖患病率的普遍增加减缓了这种下降。这两种cvrf密切相关，而“糖尿病”一词就是用来指代这种关系的。本研究的主要目的是评估糖尿病对心血管疾病死亡率的影响。方法前瞻性队列研究，在西班牙东南部一个省采用随机两阶段抽样方法，纳入1246人（54.3%为女性），随访20.9年（SD = 7.31）。糖尿病定义为DM2合并超重和肥胖。计算生存曲线（Kaplan-Meier），采用两种Cox回归模型，一种未调整，另一种由主要解释变量调整，其中糖尿病变量包括6类（正常体重、超重、肥胖、正常体重+ DM2、超重+ DM2和肥胖+ DM2）。结果CV死亡95例（7.6%，女性6.2%，男性9.3%,P = 0.01）。调整后，DM2与超重联合使心血管死亡率增加133% (HR = 2.33; 95% CI: 1.18-4.58; P =。014)， DM2与肥胖合并的患病率为49% (HR = 1.49; 95% CI: 0.64−3.45;P =。351)，在后一种情况下没有达到统计显著性。结论在普通人群中，我们的研究结果表明，超重和DM2合并与较高的CV死亡率相关。对超重和DM2的控制进行密集干预似乎是当务之急。

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引用次数: 0

Cumulative exposure to cholesterol: Lost time cannot be recovered 累积暴露于胆固醇：失去的时间无法恢复

Clínica e Investigación en Arteriosclerosis (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-06-24 DOI: 10.1016/j.artere.2025.500805

Pablo Pérez-Martínez , José López-Miranda

引用次数: 0

Correlation of the adhesion of the elements of atheroma and the causes of thrombosis 动脉粥样硬化成分的粘连与血栓形成的关系

Clínica e Investigación en Arteriosclerosis (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-06-25 DOI: 10.1016/j.artere.2025.500801

Irving Mauricio Lecona Licona , José María Rodríguez Lelis , Joaquín Pérez Ortega , José Alfredo Rodríguez Ramírez

Introduction

Ischemic diseases are the second leading cause of death in Mexico and account for over 30% of deaths worldwide. Atherosclerosis, in particular, obstructs arteries and impairs blood circulation, contributing to increased mortality and reduced quality of life.

Objective

In this study, adhesion energies and their influence on the structural arrangement of an atheroma were determined.

Methodology

Adhesion energies were measured for each main component of the atheroma, including arteries and plaque components such as cholesterol, calcium, collagen, glucose, and elastin. The relationship between adhesion and atheroma formation is demonstrated, highlighting the significant interaction of adhesion energies between fibrinogen and cholesterol. Numerical results showed that fibrinogen and cholesterol have the highest adhesion energy, followed by collagen-glucose and cholesterol-elastin combinations.

Results

Additionally, interactions with the highest adhesion energy, such as Fib-Fib with an energy value of 9.60 x 10⁻⁵ J/m², CML-GB with a value of 2.76 x 10⁻⁹ J/m², along with LDL-LDL with an adhesion value of 6.35 x 10⁻⁵ J/m² and Elas-LDL with a J value of 3.40 x 10⁻⁵ J/m², influence the atheroma structure formation.

Conclusions

These results demonstrate the association between adhesion energy in forming an atheroma that obstructs arteries, reduces blood flow, and the pathology of thrombus formation.

缺血性疾病是墨西哥的第二大死因，占全世界死亡人数的30%以上。动脉粥样硬化尤其会阻塞动脉，损害血液循环，导致死亡率上升和生活质量下降。目的研究动脉粥样硬化黏附能及其对动脉粥样硬化结构排列的影响。方法：测量动脉粥样硬化各主要成分的粘附能，包括动脉和斑块成分，如胆固醇、钙、胶原蛋白、葡萄糖和弹性蛋白。粘连和动脉粥样硬化形成之间的关系被证明，强调纤维蛋白原和胆固醇之间的粘连能量的显著相互作用。数值结果表明，纤维蛋白原和胆固醇具有最高的粘附能，其次是胶原-葡萄糖和胆固醇-弹性蛋白组合。结果黏附能最高的Fib-Fib、CML-GB、LDL-LDL黏附能分别为9.60 × 10−5 J/m2、2.76 × 10−9 J/m2、6.35 × 10−5 J/m2和3.40 × 10−5 J/m2，这些相互作用影响了动脉粥样硬化结构的形成。结论：这些结果表明，在形成阻塞动脉、减少血流量的动脉粥样硬化过程中，黏附能量与血栓形成的病理之间存在关联。

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引用次数: 0

Strategies to improve cardiovascular health and treatment of dyslipidemia in Spain. Expert Insights Project 西班牙改善心血管健康和治疗血脂异常的策略。专家洞察项目

Clínica e Investigación en Arteriosclerosis (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-06-25 DOI: 10.1016/j.artere.2025.100738

Juan Pedro-Botet , Román Freixa , Juan José Tamarit , José López-Miranda , Rosa Fernández-Olmo , Ovidio Muñiz-Grijalvo , Rafael Vázquez-García , Carlos Guijarro , Luis Rodríguez-Padial , José Luis Díaz-Díaz , Marisol Bravo-Amaro , José Luís Hernández , José Antonio Alarcón-Duque , José Alfredo Martin-Armas , Martín García-López , Juan Cosín-Sales

Objectives

To gather opinions, recommendations, and proposals for improvement from Spanish clinicians on cardiovascular (CV) health, with particular focus on dyslipidemia management.

Methods

The Expert Insights project involved 8 face-to-face sessions held throughout Spain, attended by 138 CV health experts. Clinicians answered to 25 questions survey related to CV health and dyslipidemia control. Each session included an analysis and a discussion on the perceived realities and areas for improvement.

Results

72% of centres have a standardised process for monitoring patients after a CV episode at discharge, but only 37% during their clinical follow-up. Patient care and management are dependent on the physician, with a lack of coordination between hospital specialties and primary care (PC). 95% of clinicians believe it is necessary to standarise treatment optimisation. 65% of centres prescribe combined lipid-lowering treatment after a CV episode. Updating cLDL levels in the Therapeutic Positioning Report and standardising and globalising the prescription document would reduce iPCSK9 prescription barriers and lead to more equitable access.

Conclusions

In Spain, there are significant deficiencies in the management of dyslipidemia, with a great need for a consensus on standardising management processes and optimising patient treatment. The opinions, recommendations, and improvement proposals from Spanish clinicians on CV health are an important starting point to improve the situation.

目的收集西班牙临床医生对心血管（CV）健康的意见、建议和建议，特别是对血脂异常管理的关注。方法专家洞察项目包括在西班牙各地举行的8次面对面会议，有138名心血管健康专家参加。临床医生回答了与心血管健康和血脂异常控制相关的25个问题。每届会议都包括对所认识的现实和有待改进的领域进行分析和讨论。结果：72%的中心有标准化的流程来监测出院时CV发作的患者，但在临床随访中只有37%。病人的护理和管理依赖于医生，医院专科和初级保健（PC）之间缺乏协调。95%的临床医生认为有必要规范治疗优化。65%的中心在心血管发作后给予联合降脂治疗。更新治疗定位报告中的cLDL水平，并使处方文件标准化和全球化，将减少iPCSK9处方障碍，并导致更公平的获取。结论西班牙血脂异常的管理存在明显不足，亟需在规范管理流程和优化患者治疗方面达成共识。西班牙临床医生关于心血管健康的意见、建议和改进建议是改善这种状况的重要起点。

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引用次数: 0

Identification of new therapeutic targets related to endoplasmic reticulum stress and mitochondrial dysfunction to reduce the risk of rupture in degenerative ascending aortic aneurysm 鉴定与内质网应激和线粒体功能障碍相关的新治疗靶点以降低退行性升主动脉瘤破裂的风险

Clínica e Investigación en Arteriosclerosis (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-06-25 DOI: 10.1016/j.artere.2025.100740

Rafael Almendra-Pegueros , Antonio J. Barros-Membrilla , Elvira Pérez-Marlasca , Josep Julve , José Martinez-González , Cristina Rodriguez , María Galán

Background

Ascending Thoracic Aortic Aneurysm (ATAA) is a progressive dilation of the aorta that can be complicated by its dissection leading to death in 80–90% of the patients. When associated with ageing and atherosclerosis, the outcome is worse and reconstructive surgery is the only effective therapy. Our objective was to characterise differential expressed genes (DEG) involved in endoplasmic reticulum (ER) and mitochondria dysfunction in patients with degenerative ATAA.

Methods

a transcriptomic analysis was performed by RNA sequencing using RNA isolated from ATAA of patients classified as degenerative (n = 13) and multi-organ healthy donors (n = 6). DEGs related to ER stress and mitochondrial dysfunction were identified with the DESeq2 package. Enriched pathway (Reactome) and protein interaction (PPI) analysis was performed with the clusterProfiles package. PPI of the selected DEGs was analysed based on the string database and visualised by Cytoscape software.

Results

histology revealed a complete disorganisation of the extracellular matrix (ECM) and cell loss in the aortic wall of ATAA patients where the upregulation of 15 DEGs and the downregulation of 13 DEGs that encode proteins related to ER stress (ATF4, EIF2AK3, HSPA5, ERN1, SEL1L), mitochondrial dysfunction (DNML1, IMMT, MT-CO3, MT-CYB, MT ND2, TIMM17B, MT-ERF1, TOMM5) and ECM was detected. The results of GO term and enriched pathway analysis indicated that these DEGs are mainly enriched in pathways related to aortic diseases.

Conclusions

our data show that proteins related to mitochondrial dysfunction and ER stress might be therapeutic targets for the treatment of ATAA.

胸升主动脉瘤（ATAA）是一种进行性主动脉扩张，可合并主动脉剥离，导致80-90%的患者死亡。当与衰老和动脉粥样硬化相关时，结果更糟，重建手术是唯一有效的治疗方法。我们的目的是表征与退行性ATAA患者内质网（ER）和线粒体功能障碍相关的差异表达基因（DEG）。方法采用从退行性患者（n = 13）和多器官健康供者（n = 6）的ATAA中分离的RNA进行转录组学分析。通过DESeq2包鉴定出与内质网应激和线粒体功能障碍相关的基因。富集途径（Reactome）和蛋白质相互作用（PPI）分析使用clusterProfiles包。根据字符串数据库分析所选基因的PPI，并用Cytoscape软件进行可视化。结果ATAA患者主动脉壁细胞外基质（ECM）完全紊乱，细胞丢失，其中编码内质网应激相关蛋白（ATF4、EIF2AK3、HSPA5、ERN1、SEL1L）的15个deg上调，13个deg下调，线粒体功能障碍（DNML1、IMMT、MT- co3、MT- cyb、MT ND2、TIMM17B、MT- erf1、TOMM5）和ECM。GO term和富集通路分析结果表明，这些deg主要富集在与主动脉疾病相关的通路中。结论线粒体功能障碍和内质网应激相关蛋白可能是ATAA的治疗靶点。

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引用次数: 0

Icosapent ethyl: From the REDUCE-IT trial to clinical practice 二羟戊二烯：从REDUCE-IT试验到临床实践

Clínica e Investigación en Arteriosclerosis (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-06-19 DOI: 10.1016/j.artere.2025.500820

Juan Pedro-Botet

In addition to low-density lipoproteins (LDL), those containing apolipoprotein (Apo) B and with a diameter less than 70 nm, including the smaller triglyceride-rich lipoproteins, remnant particles, and lipoprotein(a), may independently contribute to atherosclerosis because they also cross the endothelium and penetrate the arterial intima. Although mild/moderate hypertriglyceridemia is a recognized vascular risk factor, only two studies, the Japan EPA Lipid Intervention (JELIS) and the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT), using pure eicosapentaenoic acid (EPA) or icosapent ethyl (IPE), the stable ethyl ester of EPA, respectively, rather than a combination of docosahexaenoic acid (DHA) and EPA, have demonstrated a reduction in the rate of cardiovascular events. For this reason, it was deemed appropriate to examine the implications and applicability of the REDUCE-IT study in real-life settings. This analysis suggests a transversal therapeutic approach, based on both LDL cholesterol and triglycerides, for patients at very high cardiovascular risk to achieve an effective prevention. Furthermore, among patients in secondary prevention, treatment with IPE should focus on those with the highest vascular risk (recent acute coronary syndrome, post-infarction, angioplasty, and coronary bypass grafting).

除了低密度脂蛋白（LDL）外，那些含有载脂蛋白（Apo） B且直径小于70 nm的，包括较小的富含甘油三酯的脂蛋白、残余颗粒和脂蛋白(a)，可能独立地促进动脉粥样硬化，因为它们也穿过内皮并穿透动脉内膜。虽然轻度/中度高甘油三酯血症是公认的血管危险因素，但只有两项研究，即日本EPA脂质干预（JELIS）和减少心血管事件与二十碳五烯乙基干预试验（REDUCE-IT），分别使用纯二十碳六烯酸（EPA）或二十碳六烯乙基（IPE）， EPA的稳定乙酯，而不是二十二碳六烯酸（DHA）和EPA的组合，证明了心血管事件发生率的降低。出于这个原因，我们认为应该在现实环境中检查REDUCE-IT研究的含义和适用性。这一分析表明，对于心血管风险极高的患者，基于LDL胆固醇和甘油三酯的横向治疗方法可以实现有效的预防。此外，在二级预防患者中，IPE治疗应侧重于血管风险最高的患者（近期急性冠状动脉综合征、梗死后、血管成形术和冠状动脉旁路移植术）。

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引用次数: 0

Planning of lipid-lowering treatment in atherosclerotic vascular disease. Consensus SEC/SEA/SEEN/SEMFYC/SEMERGEN/SEMG/SEN/SEACV/S.E.N 动脉粥样硬化性血管疾病的降脂治疗计划。共识秒/海/看到/ SEMFYC森/ SEMERGEN /表/ / SEACV / S.E.N

Clínica e Investigación en Arteriosclerosis (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-06-24 DOI: 10.1016/j.artere.2025.500799

Rosa Fernández-Olmo , Alberto Cordero , Armando Oterino , Agustín Blanco-Echevarría , David Vivas , Carlos Escobar , Emilio Ortega , Mónica Torres-Fonseca , Carmen Sánchez-Peinador , Borja Quiroga , Vicente Pascual , Pedro Martínez-Losas , Daniel Escribano , María del Mar Freijo , Rosa María Sánchez Hernández , Ana Viana , Román Freixa-Pamias , Almudena Castro , Juan José Gómez Doblas

In recent years we have been experiencing an advance in lipid-lowering therapies, with the appearance of new drugs that act on the different metabolic pathways, reducing both the levels of cholesterol associated with low-density lipoproteins (LDL-C) containing apoprotein B (ApoB), and vascular risk. However, the results in achieving goals are still scarce, as well as the use of the different therapies that help us to achieve them. Among the reasons that justify this situation are: the inadequate identification of vascular risk, the underuse of therapies, poor adherence to the recommended treatment, the lack of organization in terms of the assignment of roles and algorithms of action in the follow-up of patients and the need for improved education and psychosocial interventions that influence both adherence and consolidation of Healthy lifestyle habits. This consensus document aims to improve the approach and follow-up of dyslipidemia in a comprehensive way, defining the planning of lipid-lowering therapies as a control strategy (SEC/SEA/SEEN/SEMFYC/SEMERGEN/SEMG/SEN/SEACV/S.E.N.).

近年来，随着作用于不同代谢途径的新药的出现，我们在降脂疗法方面取得了进展，降低了与含载脂蛋白B （ApoB）的低密度脂蛋白（LDL-C）相关的胆固醇水平和血管风险。然而，实现目标的结果仍然很少，以及使用不同的治疗方法来帮助我们实现这些目标。造成这种情况的原因包括：对血管风险的识别不足、治疗方法的使用不足、推荐治疗的依从性差、在患者随访中角色分配和行动算法方面缺乏组织，以及需要改善教育和社会心理干预，这些都影响到健康生活习惯的依从性和巩固。本共识文件旨在全面改进血脂异常的治疗方法和随访，确定降脂治疗计划作为控制策略（SEC/SEA/SEEN/SEMFYC/SEMERGEN/SEMG/SEN/SEACV/S.E.N.）。

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引用次数: 0

Hypertriglyceridemia (> 150 mg/dL) as a marker of cardiovascular risk 高甘油三酯血症（> 150 mg/dL）作为心血管风险的标志

Clínica e Investigación en Arteriosclerosis (English Edition)

Pub Date : 2025-07-01 Epub Date: 2025-06-19 DOI: 10.1016/j.artere.2025.500822

José López-Miranda

In patients who have achieved optimal LDL-C control, there remains a residual risk of atherothrombotic cardiovascular disease (ASCVD) related to alterations in lipid metabolism, among which alterations in triglyceride-rich lipoproteins and the cholesterol they contain, known as remnant cholesterol, play a major role. Remnant cholesterol is related to ASCVD risk that is independent of LDL-C and has been demonstrated in epidemiological and Mendelian randomization studies. Numerous epidemiological and genetic Mendelian randomization studies support that elevated triglyceride-rich lipoproteins (TRL) and remnant cholesterol are causally associated with ASCVD, myocardial infarction, ischemic stroke, aortic valve stenosis, and all-cause mortality. The remnant particles of triglyceride-rich lipoproteins are highly atherogenic due to their ability to enter and be retained in the arterial wall, their high cholesterol content, and their capacity to generate foam cells, induce endothelial dysfunction, a prothrombotic environment, and a vascular inflammatory response. Assessment of remnant cholesterol can provide information about residual ASCVD risk beyond that provided by LDL-C, non-HDL-C, and apoB, particularly in individuals with hypertriglyceridemia, type 2 diabetes, or metabolic syndrome.

在达到最佳LDL-C控制的患者中，仍然存在与脂质代谢改变相关的动脉粥样硬化血栓性心血管疾病（ASCVD）的残留风险，其中富含甘油三酯的脂蛋白及其所含胆固醇（称为残余胆固醇）的改变起主要作用。残余胆固醇与ASCVD风险相关，与LDL-C无关，并已在流行病学和孟德尔随机化研究中得到证实。大量流行病学和遗传孟德尔随机化研究支持富甘油三酯脂蛋白（TRL）和残余胆固醇升高与ASCVD、心肌梗死、缺血性卒中、主动脉瓣狭窄和全因死亡率有因果关系。富含甘油三酯的脂蛋白的残余颗粒具有高度的致动脉粥样硬化性，因为它们能够进入并保留在动脉壁中，它们的高胆固醇含量，以及它们产生泡沫细胞的能力，诱导内皮功能障碍，血栓形成前环境和血管炎症反应。残余胆固醇的评估可以提供比LDL-C、非hdl - c和载脂蛋白ob提供的更多关于残余ASCVD风险的信息，特别是在高甘油三酯血症、2型糖尿病或代谢综合征患者中。

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引用次数: 0