Dodani Sunita
Department of Internal Medicine, University of Kansas Medical Center, Kansas City, USA.
Open Cardiovasc Med J. 2010;4:45-50. doi: 10.2174/1874192401004020045. Epub 2010 Feb 23.
South Asian immigrants (SAIs) have a higher prevalence of cardiovascular (CV) morbidity and mortality compared with other populations. The major challenge associated with primary prevention of cardiovascular to coronary artery diseases (CAD) in SAIs involves early and accurate detection of CAD in asymptomatic individuals at high cardiovascular risk. Inflammatory processes are now recognized to play a central role in the pathogenesis of atherosclerosis and are found to be associated with future CV risk in a variety of clinical settings. Imaging measures, such as common carotid artery intima-media thickness (CCA-IMT), are being applied as surrogate markers for end-points, such as myocardial infarction (MI) and death in clinical trials. Considering high CAD risk in SAIs and knowing that conventional risk factors may not fully explain the excess CAD risk in this group, studies on the role of CCA-IMT in CAD prediction have been discussed. Also, C-reactive protein (CRP) validity in risk prediction, the role of dysfunctional high density lipoprotein (HDL) as a CAD risk marker in SAIs have been presented.
与其他人群相比,南亚移民(SAIs)心血管(CV)疾病的发病率和死亡率更高。SAIs中冠状动脉疾病(CAD)一级预防面临的主要挑战涉及在心血管高风险的无症状个体中早期准确检测CAD。现在人们认识到炎症过程在动脉粥样硬化的发病机制中起核心作用,并发现其在各种临床环境中与未来的心血管风险相关。在临床试验中,诸如颈总动脉内膜中层厚度(CCA-IMT)等成像指标正被用作心肌梗死(MI)和死亡等终点的替代标志物。鉴于SAIs中CAD风险较高,且已知传统风险因素可能无法完全解释该群体中CAD风险过高的情况,因此已对CCA-IMT在CAD预测中的作用进行了研究讨论。此外,还介绍了C反应蛋白(CRP)在风险预测中的有效性,以及功能失调的高密度脂蛋白(HDL)作为SAIs中CAD风险标志物的作用。