Department of Cardiology, The Affiliated Hospital of Qingdao University, No.1677 Wutai Mountain Road, Qingdao, 266000, China.
Lipids Health Dis. 2023 Sep 22;22(1):157. doi: 10.1186/s12944-023-01926-9.
Developments in neoadjuvant and adjuvant chemotherapy (CHT) have led to an increase in the number of breast cancer survivors. The determination of an appropriate follow-up for these patients is of increasing importance. Deaths due to cardiovascular disease (CVD) are an important part of mortality in patients with breast cancer.This review suggests that chemotherapeutic agents may influence lipoprotein(a) (Lp(a)) concentrations in breast cancer survivors after CHT based on many convincing evidence from epidemiologic and observational researches. Usually, the higher the Lp(a) concentration, the higher the median risk of developing CVD. However, more clinical trial results are needed in the future to provide clear evidence of a possible causal relationship. This review also discuss the existing and emerging therapies for lowering Lp(a) concentrations in the clinical setting. Hormone replacement therapy, statins, proprotein convertase subtilisin/kexin-type 9 (PCSK9) inhibitors, Antisense oligonucleotides, small interfering RNA, etc. may reduce circulating Lp(a) or decrease the incidence of CVD.
新辅助化疗和辅助化疗（CHT）的发展导致乳腺癌幸存者人数增加。确定这些患者的适当随访方法变得越来越重要。心血管疾病（CVD）导致的死亡是乳腺癌患者死亡的一个重要组成部分。本综述表明，基于许多来自流行病学和观察性研究的令人信服的证据，化疗药物可能会影响 CHT 后乳腺癌幸存者的脂蛋白（a）（Lp(a)）浓度。通常，Lp(a)浓度越高，发生 CVD 的中位风险就越高。然而，未来还需要更多的临床试验结果来提供可能存在因果关系的明确证据。本综述还讨论了目前和新出现的降低 Lp(a)浓度的治疗方法。激素替代疗法、他汀类药物、前蛋白转化酶枯草溶菌素/激肽释放酶 9（PCSK9）抑制剂、反义寡核苷酸、小干扰 RNA 等可能会降低循环 Lp(a)或降低 CVD 的发生率。
