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脂蛋白(a)与心力衰竭:一项系统评价

Lipoprotein(a) and heart failure: a systematic review.

作者信息

Masson Walter, Barbagelata Leandro, Lavalle-Cobo Augusto, Corral Pablo, Nogueira Juan P

机构信息

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.

出版信息

Heart Fail Rev. 2023 Nov;28(6):1307-1314. doi: 10.1007/s10741-023-10333-2. Epub 2023 Jul 19.


DOI:10.1007/s10741-023-10333-2
PMID:37466712
Abstract

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.

摘要

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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引用本文的文献

[1]
The correlation between lipoprotein(a) and major adverse cardiovascular events in patients with acute myocardial infarction combined with heart failure with preserved ejection fraction.

Front Cardiovasc Med. 2025-6-9

[2]
Lipoprotein(a) and panvascular disease.

Lipids Health Dis. 2025-5-24

[3]
Lipoprotein(a) as a Causal Risk Factor for Cardiovascular Disease.

Curr Cardiovasc Risk Rep. 2025

[4]
Causal relationships between uremic metabolites or toxins and heart failure: Univariate and multivariate Mendelian randomization.

Medicine (Baltimore). 2024-11-22

[5]
Lipoprotein(a) and Atrial Fibrillation: Mechanistic Insights and Therapeutic Approaches.

Int J Med Sci. 2025-1-1

本文引用的文献

[1]
Hypertensive heart disease: risk factors, complications and mechanisms.

Front Cardiovasc Med. 2023-6-5

[2]
Understanding the Mechanisms and Treatment of Heart Failure: Quantitative Systems Pharmacology Models with a Focus on SGLT2 Inhibitors and Sex-Specific Differences.

Pharmaceutics. 2023-3-20

[3]
A Systematic Review on the Risk Modulators of Myocardial Infarction in the "Young"-Implications of Lipoprotein (a).

Int J Mol Sci. 2023-3-21

[4]
High lipoprotein(a) levels and mitral valve disease: A systematic review.

Nutr Metab Cardiovasc Dis. 2023-5

[5]
Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement.

Eur Heart J. 2022-10-14

[6]
Lipoprotein (a) and diabetes mellitus.

Atherosclerosis. 2022-5

[7]
Association of lipoprotein (a) and 1 year prognosis in patients with heart failure with reduced ejection fraction.

ESC Heart Fail. 2022-8

[8]
Global burden of heart failure: a comprehensive and updated review of epidemiology.

Cardiovasc Res. 2023-1-18

[9]
Alirocumab after acute coronary syndrome in patients with a history of heart failure.

Eur Heart J. 2022-4-19

[10]
Lipoprotein (a) and Hypertension.

Curr Hypertens Rep. 2021-12-9

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