西班牙动脉硬化学会脂蛋白(a)共识。文献综述和临床实践建议。

IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE Clinica e Investigacion en Arteriosclerosis Pub Date : 2024-07-01 DOI:10.1016/j.arteri.2024.03.002
Javier Delgado-Lista , Jose M. Mostaza , Teresa Arrobas-Velilla , Francisco Blanco-Vaca , Luis Masana , Juan Pedro-Botet , Pablo Perez-Martinez , Fernando Civeira , Jose I. Cuende-Melero , Jose J. Gomez-Barrado , Carlos Lahoz , Xavier Pintó , Manuel Suarez-Tembra , Jose Lopez-Miranda , Carlos Guijarro
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引用次数: 0

摘要

脂蛋白(a)(Lp(a))在心血管风险因素研究中的应用,可能是几十年来该领域最大的新发现,此外还有丙蛋白转化酶枯草酶/kexin 9 型(iPCSK9)抑制剂药物的发现和使用。脂蛋白(a)浓度(尤其是极高浓度)与某些心血管并发症(如动脉粥样硬化性血管疾病(AVD)和主动脉狭窄)有着不可否认的联系。然而,目前在确定流行病学关联和特定药物治疗方面都存在一些局限性。首先,脂蛋白(a)的测量高度依赖于所使用的检测方法,这主要是因为该分子的特性。其次,脂蛋白(a)的浓度 80% 以上是由基因决定的,因此,与其他心血管风险因素不同,脂蛋白(a)无法通过改变生活方式来调节。最后,尽管有许多临床试验表明,使用特定药物来降低脂蛋白(a)是有希望的,但目前只有 iPCSK9(因其成本而使用受限)能显著降低脂蛋白(a)。然而,与其他科学协会一样,东南欧医学协会认为,为了增加人们对脂蛋白(a)导致心血管风险的了解,有必要编写一份文件,介绍该主题的现状、控制脂蛋白(a)升高人群的总体心血管风险的建议以及对脂蛋白(a)升高患者的治疗方法的建议。
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Consenso sobre lipoproteína (a) de la Sociedad Española de Arteriosclerosis. Revisión bibliográfica y recomendaciones para la práctica clínica

The irruption of lipoprotein(a) (Lp(a)) in the study of cardiovascular risk factors is perhaps, together with the discovery and use of proprotein convertase subtilisin/kexin type 9 (iPCSK9) inhibitor drugs, the greatest novelty in the field for decades. Lp(a) concentration (especially very high levels) has an undeniable association with certain cardiovascular complications, such as atherosclerotic vascular disease (AVD) and aortic stenosis. However, there are several current limitations to both establishing epidemiological associations and specific pharmacological treatment. Firstly, the measurement of Lp(a) is highly dependent on the test used, mainly because of the characteristics of the molecule. Secondly, Lp(a) concentration is more than 80% genetically determined, so that, unlike other cardiovascular risk factors, it cannot be regulated by lifestyle changes. Finally, although there are many promising clinical trials with specific drugs to reduce Lp(a), currently only iPCSK9 (limited for use because of its cost) significantly reduces Lp(a).

However, and in line with other scientific societies, the SEA considers that, with the aim of increasing knowledge about the contribution of Lp(a) to cardiovascular risk, it is relevant to produce a document containing the current status of the subject, recommendations for the control of global cardiovascular risk in people with elevated Lp(a) and recommendations on the therapeutic approach to patients with elevated Lp(a).

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来源期刊
Clinica e Investigacion en Arteriosclerosis
Clinica e Investigacion en Arteriosclerosis PERIPHERAL VASCULAR DISEASE-
CiteScore
3.20
自引率
6.20%
发文量
44
审稿时长
40 days
期刊介绍: La publicación idónea para acceder tanto a los últimos originales de investigación como a formación médica continuada sobre la arteriosclerosis y su etiología, epidemiología, fisiopatología, diagnóstico y tratamiento. Además, es la publicación oficial de la Sociedad Española de Arteriosclerosis.
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