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探讨脂蛋白(a)水平与心肌梗死风险的关系:一项观察性研究。

Exploring the Relationship Between Lipoprotein (a) Level and Myocardial Infarction Risk: An Observational Study.

机构信息

Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

出版信息

Medicina (Kaunas). 2024 Nov 16;60(11):1878. doi: 10.3390/medicina60111878.

Abstract

: This observational study investigates the relationship between Lipoprotein (a) (Lp(a)) levels and the risk of acute myocardial infarction (AMI). This study aims to highlight the association of elevated Lipoprotein (a) levels with an increased atherogenic profile and the potential risk of AMI. : We conducted a case-control study involving 106 individuals, including 64 AMI patients (both STEMI and NSTEMI) and 42 healthy controls. Comprehensive clinical and biochemical assessments, including Lp(a) measurements, were conducted. : Patients with Lp(a) levels ≥ 30 mg/dL had a threefold increased risk of AMI compared to those with lower levels, independent of traditional risk factors such as cholesterol, smoking, and body weight. Elevated Lp(a) was observed in 50% of AMI patients compared to 28.57% in controls ( = 0.028). Notably, a multivariate analysis identified high Lp(a) levels, low HDL-C levels, and obesity as significant independent predictors of AMI, indicating these factors may contribute to AMI risk more prominently than other conventional risk factors in patients with elevated Lp(a). Moreover, the association between Lp(a) and AMI risk was consistent across various patient subgroups, with low HDL-C further compounding the risk. : Lp(a) is a significant independent risk factor for acute myocardial infarction; therefore, screening for Lp(a) levels can help identify high-risk individuals beyond traditional markers. Therapeutic approaches targeting Lp(a) may reduce AMI incidence. Future research should explore how Lp(a) promotes atherosclerosis and assess Lp(a)-lowering therapies to improve patient outcomes.

摘要

本观察性研究旨在探讨脂蛋白 (a)(Lp(a))水平与急性心肌梗死 (AMI) 风险之间的关系。本研究旨在强调升高的脂蛋白 (a) 水平与动脉粥样硬化形成增加的相关性,以及发生 AMI 的潜在风险。

我们进行了一项病例对照研究,纳入了 106 名个体,包括 64 名 AMI 患者(ST 段抬高型心肌梗死和非 ST 段抬高型心肌梗死)和 42 名健康对照者。进行了全面的临床和生化评估,包括 Lp(a) 测量。

与 Lp(a) 水平较低的患者相比,Lp(a) 水平≥30mg/dL 的患者发生 AMI 的风险增加了三倍,独立于胆固醇、吸烟和体重等传统危险因素。与对照组的 28.57%相比,AMI 患者中有 50%存在 Lp(a) 升高(=0.028)。值得注意的是,多变量分析确定高 Lp(a) 水平、低 HDL-C 水平和肥胖是 AMI 的显著独立预测因子,表明这些因素在 Lp(a) 升高的患者中可能比其他传统危险因素更显著地导致 AMI 风险。此外,Lp(a) 与 AMI 风险之间的关联在各种患者亚组中是一致的,低 HDL-C 进一步增加了风险。

Lp(a) 是急性心肌梗死的重要独立危险因素;因此,筛查 Lp(a) 水平可以帮助识别传统标志物之外的高危个体。针对 Lp(a) 的治疗方法可能会降低 AMI 的发生率。未来的研究应探讨 Lp(a) 如何促进动脉粥样硬化,并评估 Lp(a) 降低治疗方法以改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af58/11596715/bce9b6e2a289/medicina-60-01878-g001.jpg

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