从心脏外科医生的角度看脂蛋白（a）与降脂治疗。对主动脉瓣置换患者及心脏移植后患者预后的影响。

Lipoprotein (a) and lipid-lowering treatment from the perspective of a cardiac surgeon. An impact on the prognosis in patients with aortic valve replacement and after heart transplantation.

作者信息

Surma Stanisław, Zembala Michał O, Okopień Bogusław, Banach Maciej

机构信息

Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752, Katowice, Poland.

Department of Cardiac Surgery and Transplantology, Faculty of Medicine, John Paul II Catholic University in Lublin, Poland.

出版信息

Int J Cardiol Cardiovasc Risk Prev. 2024 Jun 6;22:200297. doi: 10.1016/j.ijcrp.2024.200297. eCollection 2024 Sep.

DOI:10.1016/j.ijcrp.2024.200297

PMID:38962113

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11219948/

Abstract

Lipoprotein(a) is a recognized risk factor for ASCVD. There is still no targeted therapy for Lp(a), however, drugs such as pelacarsen, olpasiran, zerlasiran, lepodisiran and muvalaplin are in clinical trials and have been shown to be effective in significantly reducing Lp(a) levels. Moreover, elevated Lp(a) levels significantly affect the prognosis of patients after aortic valve replacement (AVR) and heart transplantation (HTx). Therefore, the assessment of Lp(a) concentration in these patients will allow for a more accurate stratification of their cardiovascular risk, and the possibility of lowering Lp(a) will allow for the optimization of this risk. In this article, we summarized the most important information regarding the role of Lp(a) and lipid-lowering treatment in patients after AVR and HTx.

摘要

脂蛋白(a)是公认的动脉粥样硬化性心血管疾病（ASCVD）的危险因素。然而，目前仍没有针对脂蛋白(a)的靶向治疗方法，不过，诸如佩卡塞尼、奥帕西兰、泽拉西兰、莱波迪西兰和穆瓦拉普林等药物正在进行临床试验，并且已显示出能有效显著降低脂蛋白(a)水平。此外，升高的脂蛋白(a)水平会显著影响主动脉瓣置换术（AVR）和心脏移植术（HTx）后患者的预后。因此，评估这些患者的脂蛋白(a)浓度将有助于更准确地对其心血管风险进行分层，而降低脂蛋白(a)的可能性将有助于优化这种风险。在本文中，我们总结了关于脂蛋白(a)的作用以及AVR和HTx后患者降脂治疗的最重要信息。