血浆脂蛋白(a)浓度很高但心血管后果很少的老年患者:病例系列。

IF 1.4 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Journal of International Medical Research Pub Date : 2024-08-01 DOI:10.1177/03000605241271876
Shyann Hang, Robert A Hegele
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引用次数: 0

摘要

脂蛋白(a)(Lp(a))是一种类似于低密度脂蛋白(LDL)的致动脉粥样硬化颗粒,目前被认为是动脉粥样硬化性心血管疾病的一种不可改变的危险因素。近年来,发现脂蛋白(a)浓度升高的患者人数不断增加,但这一发现对患者和医生的影响尚不明确。我们在血脂门诊数据库中筛选了年龄大于 65 岁、脂蛋白(a)浓度极高(定义为大于 230 nmol/L)的患者,并对其心血管预后进行了评估。患者(n = 16)的平均年龄(±标准差)为 72.2 ± 7.1 岁,平均脂蛋白(a)浓度为 313 ± 68 nmol/L。经过累计 129.0 年的随访(平均:8.1 ± 4.2 年),患者的平均年龄为 80.3 ± 7.0 岁。我们观察到心血管事件的基线发生率较低,只有两名患者有心血管事件病史。此外,随访期间记录的不良心血管事件为零。因此,极高的脂蛋白(a)浓度和无病老年并不相互排斥。我们积累的临床经验表明,脂蛋白(a)浓度升高与不良预后之间的关系不大。尽管如此,我们仍建议对这些患者进行可改变风险因素的治疗。
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Elderly patients with very high plasma lipoprotein(a) concentrations and few cardiovascular consequences: a case series.

Lipoprotein(a) (Lp(a)) is an atherogenic low-density lipoprotein (LDL)-like particle that is currently regarded as a non-modifiable risk factor for atherosclerotic cardiovascular disease. The number of patients detected with elevated Lp(a) concentrations has been increasing in recent years, although the implication of this finding is unclear for patients and physicians. We screened our lipid clinic database for patients aged >65 years with very high Lp(a) concentrations, which were defined as >230 nmol/L, and cardiovascular outcomes were assessed. The patients' (n = 16) mean (±standard deviation) age was 72.2 ± 7.1 years and the mean Lp(a) concentration was 313 ± 68 nmol/L. After a cumulative 129.0 patient-year follow-up (mean: 8.1 ± 4.2 years), the mean age was 80.3 ± 7.0 years. We observed a low baseline prevalence of cardiovascular events, with only two patients having a history of cardiovascular events. Furthermore, zero incident adverse cardiovascular events were recorded over the follow-up. Therefore, very high Lp(a) concentrations and disease-free old age are not mutually exclusive. Our aggregated clinical experience is that there is only a modest association between elevated Lp(a) concentrations and adverse outcomes. Nonetheless, we still advise treating modifiable risk factors in these patients.

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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
555
审稿时长
1 months
期刊介绍: _Journal of International Medical Research_ is a leading international journal for rapid publication of original medical, pre-clinical and clinical research, reviews, preliminary and pilot studies on a page charge basis. As a service to authors, every article accepted by peer review will be given a full technical edit to make papers as accessible and readable to the international medical community as rapidly as possible. Once the technical edit queries have been answered to the satisfaction of the journal, the paper will be published and made available freely to everyone under a creative commons licence. Symposium proceedings, summaries of presentations or collections of medical, pre-clinical or clinical data on a specific topic are welcome for publication as supplements. Print ISSN: 0300-0605
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