Meeusen Jeffrey W, Donato Leslie J, Jaffe Allan S
Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
Department of Cardiology, Mayo Clinic, Rochester, MN, USA.
Curr Cardiol Rep. 2017 Jun;19(6):48. doi: 10.1007/s11886-017-0863-9.
The objective of this review was to summarize evidence gathered for the prognostic value of routine and novel blood lipids and lipoproteins measured in patients with acute coronary syndromes (ACS).
Data supports clear association with risk and actionable value for non-high-density lipoprotein (Non-HDL) cholesterol and plasma ceramides in a setting of ACS. The prognostic value and clinical actionability of apolipoprotein B (apoB) and lipoprotein(a) [Lp(a)] in ACS have not been thoroughly tested, while the data for omega-3 fatty acids and oxidized low-density lipoprotein (Ox-LDL) are either untested or more varied. Measuring basic lipids, which should include Non-HDL cholesterol, at the time of presentation for ACS is guideline mandated. Plasma ceramides also provide useful information to guide both treatment decisions and follow-up. Additional studies targeting ACS patients are necessary for apoB, Lp(a), omega-3 fatty acids, and Ox-LDL.
本综述的目的是总结急性冠状动脉综合征(ACS)患者中常规和新型血脂及脂蛋白的预后价值所收集到的证据。
数据支持在ACS情况下,非高密度脂蛋白(Non-HDL)胆固醇和血浆神经酰胺与风险有明确关联且具有可采取行动的价值。载脂蛋白B(apoB)和脂蛋白(a)[Lp(a)]在ACS中的预后价值和临床可操作性尚未得到充分测试,而ω-3脂肪酸和氧化型低密度脂蛋白(Ox-LDL)的数据要么未经测试,要么差异更大。在ACS就诊时测量基本血脂(应包括非高密度脂蛋白胆固醇)是指南规定的。血浆神经酰胺也为指导治疗决策和随访提供有用信息。针对apoB、Lp(a)、ω-3脂肪酸和Ox-LDL,有必要对ACS患者进行更多研究。