低密度脂蛋白亚型与冠状动脉钙化评分和动脉粥样硬化性心血管疾病事件的长期关联:来自 HeartSCORE 研究的启示

IF 3.6 3区 医学 Q2 PHARMACOLOGY & PHARMACY Journal of clinical lipidology Pub Date : 2024-08-13 DOI:10.1016/j.jacl.2024.08.003
Alaa Sayed MD MSc, Justin Swanson, Kevin Kip, Eshika Kumari Jesrani, Steven Reis, Anum Saeed MD
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引用次数: 0

摘要

低密度脂蛋白(LDL)胆固醇升高与动脉粥样硬化性心血管疾病(ASCVD)的风险有关。然而,中年期低密度脂蛋白亚型与长期临床和亚临床 ASCVD 的关系仍然未知。我们研究了低密度脂蛋白模式与亚临床 ASCVD 的关系。我们对心脏策略集中风险评估(Heart SCORE)研究参与者的低密度脂蛋白亚型进行了评估。计算了基线冠状动脉钙(CAC)评分,并评估了长期ASCVD事件。计算了调整后的几率比和危险比(95 % CI),以估计低密度脂蛋白模式与 CAC 和 ASCVD 事件之间的独立关联,并按性别和种族进行分层。1,884 名参与者(年龄为 59 ± 7.5 岁,66 % 为女性,44 % 为黑人)参与了生存分析;其中 740 人的子集(年龄为 60.7 ± 7.3 岁,44 % 为女性,47 % 为黑人)进行了 CAC 评分评估。LDL 模式为 AB 的男性和黑人的 CAC 评分呈阳性的几率更高(ORmen,patternAB = 2.47,95 % CI [1.11-5.58])。低密度脂蛋白模式 B(HR = 1.98,95 % CI [1.22-3.21];p 值 < 0.05)和 AB(HR = 1.54,95 % CI [1.00-2.38];p 值 < 0.05)的个体发生 ASCVD 事件的风险更高。自我认定为B型和AB型的黑人发生ASCVD事件的风险更高。在黑人和白人社区居民队列中,低密度脂蛋白B型和AB型发生ASCVD事件的风险较高。在男性和黑人中,AB型与CAC阳性相关。需要进一步研究基于种族和性别的低密度脂蛋白模式对 ASCVD 风险的影响,以制定准确的 ASCVD 预防策略。
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Long term association of low-density lipoprotein subtypes with coronary artery calcium score and atherosclerotic cardiovascular disease events: Insights from HeartSCORE study
Elevated low-density lipoprotein (LDL) cholesterol is associated with risk of atherosclerotic cardiovascular disease (ASCVD). However, the association of midlife LDL subtypes in long-term clinical and subclinical ASCVD remains unknown. We examine LDL pattern associations with subclinical ASCVD. LDL subtypes were assessed in the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study participants. Baseline coronary artery calcium (CAC) scores were calculated and long-term ASCVD events were assessed. Adjusted odds ratios and hazard ratios (95 % CI) were calculated to estimate the independent association between LDL patterns and CAC and ASCVD events, stratified by sex and race. 1,884 participants (age 59 ± 7.5 years. 66 % women, 44 % Black) were involved in the survival analysis; a subset of 740 (age 60.7 ± 7.3 years, 44 % women and 47 % Black) had their CAC score assessed. Men and Black individuals with LDL pattern AB had higher odds for positive CAC score (ORmen,patternAB = 2.47, 95 % CI [1.11-5.58]). Individuals with LDL patterns B (HR = 1.98, 95 % CI [1.22-3.21]; p-value < 0.05) and AB (HR = 1.54, 95 % CI of [1.00-2.38]; p-value < 0.05) were at a higher risk of ASCVD events. Self-identified Black individuals with type B and AB had higher risk of ASCVD events. In cohort of Black and White community dwellers, LDL patterns B and AB showed a higher risk of ASCVD events. Pattern AB was associated with positive CAC in men and Black individuals. Further studies investigating LDL patterns in ASCVD risk based on race and sex are needed to drive precise preventive strategies for ASCVD.
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来源期刊
CiteScore
7.00
自引率
6.80%
发文量
209
审稿时长
49 days
期刊介绍: Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.
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