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脂蛋白(a)与低风险男性心血管事件相关:来自长期随访健康体检队列的结果

Lipoprotein(a) is Associated with Cardiovascular Events in Low Risk Males: Results from a Health Checkup Cohort with Long-Term Follow-Up.

作者信息

Huang Yi-Chun, Cheng Yu-Wen, Wu Victor Chien-Chia, Lin Chia-Pin, Kao Yi-Wei, Chu Pao-Hsien, Lin Yu-Sheng

机构信息

Division of Cardiology, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University.

Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University.

出版信息

Acta Cardiol Sin. 2022 May;38(3):381-390. doi: 10.6515/ACS.202205_38(3).20211225A.

Abstract

OBJECTIVE

Elevated lipoprotein(a) level is an independent risk factor for atherosclerotic cardiovascular disease. However, the strength of this association in healthy individuals is unknown.

METHODS

In this retrospective cohort study, we reviewed medical records obtained from a Health Examination Program. The records, covering the period 2002-2015, were from 2,634 men at low risk, as indicated by their Framingham Risk Score and Systematic Coronary Risk Evaluation (SCORE) score, and included lipoprotein(a) data. We categorized the participants on the basis of their lipoprotein(a) level and analyzed the association of this level with cardiovascular events.

RESULTS

The study population had a mean age of 46 years. In total, 32 cardiovascular disease events - 6 strokes and 26 coronary artery events - were identified. An increase of 5 mg/dL in the lipoprotein(a) level (independent of low-density cholesterol) raised the cardiovascular disease risk by 8% over a period of 10 years (p = 0.014). Sensitivity analysis also yielded this result, even after excluding hypertension and diabetes.

CONCLUSIONS

Elevated lipoprotein(a) may be a risk factor for coronary artery disease, even in male populations defined as having a low risk according to the Framingham Risk Score and SCORE.

摘要

目的

脂蛋白(a)水平升高是动脉粥样硬化性心血管疾病的独立危险因素。然而,这种关联在健康个体中的强度尚不清楚。

方法

在这项回顾性队列研究中,我们查阅了从健康检查项目中获得的医疗记录。这些记录涵盖2002年至2015年期间,来自2634名低风险男性,其弗明汉风险评分和系统性冠状动脉风险评估(SCORE)评分表明了他们的低风险状态,且包含脂蛋白(a)数据。我们根据参与者的脂蛋白(a)水平对其进行分类,并分析该水平与心血管事件的关联。

结果

研究人群的平均年龄为46岁。总共识别出32例心血管疾病事件——6例中风和26例冠状动脉事件。脂蛋白(a)水平每升高5mg/dL(独立于低密度胆固醇),在10年期间心血管疾病风险增加8%(p=0.014)。敏感性分析也得出了这一结果,即使排除高血压和糖尿病患者后也是如此。

结论

即使在根据弗明汉风险评分和SCORE被定义为低风险的男性人群中,脂蛋白(a)升高也可能是冠状动脉疾病的一个危险因素。

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