利用遗传升高的脂蛋白(a)水平预测女性冠心病相关5年主要不良心血管事件的优势。

Advantages of using Genetically Elevated Lipoprotein(a) Levels in Predicting 5-Year Major Adverse Cardiovascular Events Relating to Coronary Artery Disease in Women.

作者信息

Shek Aleksandr B, Alieva Rano B, Abdullaev Alisher A, Fozilov Khurshid G, Khoshimov Shavkat U, Abdullaeva Guzal J, Zakirova Darya V, Kurbanova Rano A, Kan Lilya E, Kim Andrey R

机构信息

Republican Specialized Scientific and Practical Medical Center for Cardiology, Ministry of Health of the Republic Uzbekistan, 100052 Tashkent, Uzbekistan.

Center for Advanced Technologies, Ministry of Higher Education, Science and Innovation of the Republic Uzbekistan, 100174 Tashkent, Uzbekistan.

出版信息

Rev Cardiovasc Med. 2024 Aug 23;25(8):308. doi: 10.31083/j.rcm2508308. eCollection 2024 Aug.

DOI:10.31083/j.rcm2508308

PMID:39228502

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11366988/

Abstract

BACKGROUND

This study aimed to investigate major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD) over 5 years, in general, and depending on sex, lipoprotein(a) level, and number of kringle IV type 2 (KIV-2) repeats in the Lipoprotein(A) () gene.

METHODS

This study comprised 216 patients (120 women and 96 men) hospitalized with a diagnosis of "CAD, unstable angina IIB class". The three-point risk of MACEs was assessed over 5 years: cardiovascular death, non-fatal myocardial infarction, and stroke. The number of KIV-2 repeats in the gene was determined by quantitative real-time polymerase chain reaction (qPCR).

RESULTS

The relative risk of MACE in patients with elevated lipoprotein(a) (Lp(a)) was 2.0 (95% CI 1.04-3.87, 0.05) for quartile 4 (Q4) 48 mg/dL versus quartile 1 (Q1) 6 mg/dL. This was mainly attributable to an increase in men-relative risk (RR) 2.6 (95% CI 1.10-6.16, 0.05)-but not in women: RR 1.4 (95% CI 0.50-3.92). Mean lipoprotein(a) levels were inversely correlated with 42.5 and 7.5 for Q1 and Q4 KIV-2 repeat numbers, respectively. The relative risks of MACE for Q1 vs. Q4 KIV-2 repeats were as follows: 3.0 (95% CI 1.48-6.08, 0.001) for all patients; 3.0 (95% CI 1.20-6.55, 0.01) for men; 3.3 (95% CI 1.02-10.4, 0.05) for women.

CONCLUSIONS

Quantifying kringle IV type 2 repeat copy number in the gene using qPCR more accurately reflects the risk of major adverse cardiovascular events within 5 years in women with coronary artery disease.

摘要

背景

本研究旨在调查冠心病（CAD）患者5年内的主要不良心血管事件（MACE），总体情况以及根据性别、脂蛋白（a）水平和脂蛋白（A）（Lp（a））基因中kringle IV 型2（KIV-2）重复序列的数量进行调查。

方法

本研究纳入了216例诊断为“CAD，不稳定型心绞痛IIB级”的住院患者（120名女性和96名男性）。评估了5年内MACE的三点风险：心血管死亡、非致命性心肌梗死和中风。通过定量实时聚合酶链反应（qPCR）确定Lp（a）基因中KIV-2重复序列的数量。

结果

脂蛋白（a）（Lp（a））升高的患者中，四分位数4（Q4）≥48 mg/dL与四分位数1（Q1）≤6 mg/dL相比，MACE的相对风险为2.0（95%CI 1.04-3.87，P = 0.05）。这主要归因于男性相对风险增加（RR 2.6，95%CI 1.10-6.16，P = 0.05），而女性没有：RR 1.4（95%CI 0.50-3.92）。平均脂蛋白（a）水平与Q1和Q4的KIV-2重复序列数量分别呈负相关，相关系数分别为42.5和7.5。Q1与Q4的KIV-2重复序列相比，MACE的相对风险如下：所有患者为3.0（95%CI 1.48-6.08，P = 0.001）；男性为3.0（95%CI 1.20-6.55，P = 0.01）；女性为3.3（95%CI 1.02-10.4，P = 0.05）。