Masson Walter, Barbagelata Leandro, Lavalle-Cobo Augusto, Corral Pablo, Nogueira Juan P
Cardiology Department, Hospital Italiano de Buenos Aires, Perón 4190, Ciudad Autónoma de Buenos Aires, C1199ABB, Buenos Aires, Argentina.
Servicio de Cardiología, Sanatorio Finochietto, Buenos Aires, Argentina.
Heart Fail Rev. 2023 Nov;28(6):1307-1314. doi: 10.1007/s10741-023-10333-2. Epub 2023 Jul 19.
The role of lipoprotein(a) [Lp(a)] as a possible causal risk factor for atherosclerotic artery disease and aortic valve stenosis has been well established. However, the information on the association between Lp(a) levels and heart failure (HF) is limited and controversial. The main objective of the present study was to assess the association between Lp(a) levels and HF. This systematic review was performed according to PRISMA guidelines. A literature search was performed to detect studies that evaluated the association between Lp(a) levels and HF. Eight studies, including 73,410 patients, were eligible for this research. Seven prospective or retrospective cohorts and one cross-sectional study were analyzed. Five studies analyzed populations without HF; another three included patients with HF or left ventricular dysfunction. The endpoints evaluated varied according to the study analyzed, including incident HF, HF hospitalizations, and decreased left ventricular ejection fraction. Lp(a) levels were also analyzed in different ways, including analysis of Lp(a) as a continuous or categorical variable (distinct cut-off points or percentiles). Globally, the studies included in this review found predominantly positive results. Data on some relevant subgroups, such as HF of ischemic or non-ischemic etiology or HF with or without left ventricular dysfunction, was poorly reported. This systematic review suggests that there would be a positive relationship between Lp(a) levels and HF. Given the complexity and heterogeneity of HF, new studies should be developed to clarify this topic.
脂蛋白(a)[Lp(a)]作为动脉粥样硬化性动脉疾病和主动脉瓣狭窄可能的因果风险因素,其作用已得到充分证实。然而,关于Lp(a)水平与心力衰竭(HF)之间关联的信息有限且存在争议。本研究的主要目的是评估Lp(a)水平与HF之间的关联。本系统评价按照PRISMA指南进行。进行文献检索以查找评估Lp(a)水平与HF之间关联的研究。八项研究符合本研究条件,共纳入73410例患者。分析了七项前瞻性或回顾性队列研究和一项横断面研究。五项研究分析了无HF的人群;另外三项研究纳入了HF或左心室功能障碍患者。根据所分析的研究,评估的终点各不相同,包括新发HF、HF住院以及左心室射血分数降低。Lp(a)水平也以不同方式进行分析,包括将Lp(a)作为连续变量或分类变量(不同的切点或百分位数)进行分析。总体而言,本综述纳入的研究主要得出阳性结果。关于一些相关亚组的数据,如缺血性或非缺血性病因的HF或有或无左心室功能障碍的HF,报道较少。本系统评价表明,Lp(a)水平与HF之间可能存在正相关关系。鉴于HF的复杂性和异质性,应开展新的研究以阐明这一主题。
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