Agarwala Anandita, Liu Jing, Ballantyne Christie M, Virani Salim S
Division of Cardiology, Washington University School of Medicine, 660 S. Euclid, Campus Box 8086, St. Louis, MO.
Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston TX.
Curr Cardiovasc Risk Rep. 2019;13(7). doi: 10.1007/s12170-019-0616-y. Epub 2019 May 23.
In 2018, the AHA/ACC multi-society Cholesterol Guidelines introduced the novel concept of risk-enhancing factors to be used as a supplement to the pooled cohort risk equations to personalize atherosclerotic cardiovascular disease risk assessment in primary prevention. In this review, we discuss the rationale and evidence behind each of the risk- enhancing factors to help clinicians perform a more personalized cardiovascular risk assessment.
The risk-enhancing factors are high-risk features that may guide the use of lipid-lowering therapy particularly in intermediate and select borderline risk patients. For the purpose of this review, these factors are divided into 5 categories: (i) race and genetics, (ii) conditions specific to women (iii) lipid related risk, (iv) concurrent high-risk medical conditions, and (v) biomarkers.
The addition of the risk-enhancing factors to the pooled cohort equations provides a more individualized and comprehensive approach to cardiovascular disease risk assessment.
2018年，美国心脏协会（AHA）/美国心脏病学会（ACC）多学会胆固醇指南引入了风险增强因素这一新概念，作为汇总队列风险方程的补充，用于在一级预防中对动脉粥样硬化性心血管疾病风险评估进行个性化。在本综述中，我们讨论了每个风险增强因素背后的基本原理和证据，以帮助临床医生进行更个性化的心血管风险评估。
风险增强因素是高风险特征，可能指导降脂治疗的使用，特别是在中度和特定边缘风险患者中。出于本综述的目的，这些因素分为5类：（i）种族和遗传学，（ii）女性特有的情况，（iii）脂质相关风险，（iv）并发的高风险医疗状况，以及（v）生物标志物。
将风险增强因素添加到汇总队列方程中，为心血管疾病风险评估提供了一种更个性化和全面的方法。
