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非传统心血管危险因素:个体化评估及临床意义

Non-Traditional Cardiovascular Risk Factors: Tailored Assessment and Clinical Implications.

作者信息

Perone Francesco, Bernardi Marco, Spadafora Luigi, Betti Matteo, Cacciatore Stefano, Saia Francesco, Fogacci Federica, Jaiswal Vikash, Asher Elad, Paneni Francesco, De Rosa Salvatore, Banach Maciej, Biondi Zoccai Giuseppe, Sabouret Pierre

机构信息

Cardiac Rehabilitation Unit, Rehabilitation Clinic "Villa delle Magnolie", 81020 Castel Morrone, Caserta, Italy.

Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.

出版信息

J Cardiovasc Dev Dis. 2025 Apr 28;12(5):171. doi: 10.3390/jcdd12050171.

Abstract

Non-traditional cardiovascular risk factors (RFs) are increasingly emerging as important modifiers of cardiovascular risk (CVR), offering insights beyond traditional metrics like hypertension, diabetes, and dyslipidemia. These include novel biomarkers, chronic conditions (e.g., chronic kidney disease and chronic obstructive pulmonary disease), environmental exposures, chronic inflammation, infections, psychosocial factors, and sex-specific conditions, all of which influence the prediction, management, and outcomes of cardiovascular disease (CVD). These additional RFs may impact on CVD prediction and add valid information during tailored patient assessment and management. Therefore, a careful assessment of both traditional and non-traditional cardiovascular RFs, with a personalized treatment, could dramatically reduce the total CVD burden. Nevertheless, further research is needed to precisely estimate the magnitude of their impact as risk and prognosis modifiers in order to be included in future risk charts. This review provides a critical analysis of non-traditional RFs, their pathophysiological mechanisms, and their implications for personalized care. Integrating these factors into CVR assessment can reclassify patient risk categories, optimize therapeutic strategies, and improve prognosis. However, further research is needed to refine their inclusion in risk charts and evaluate their impact on public health outcomes. A tailored, multidisciplinary approach is essential to reduce the burden of CVD and associated mortality.

摘要

非传统心血管危险因素(RFs)正日益成为心血管风险(CVR)的重要调节因素,为超越高血压、糖尿病和血脂异常等传统指标提供了新的见解。这些因素包括新型生物标志物、慢性疾病(如慢性肾脏病和慢性阻塞性肺疾病)、环境暴露、慢性炎症、感染、心理社会因素以及特定性别的状况,所有这些都会影响心血管疾病(CVD)的预测、管理和预后。这些额外的危险因素可能会影响CVD的预测,并在针对患者的评估和管理过程中提供有效的信息。因此,对传统和非传统心血管危险因素进行仔细评估,并采取个性化治疗,可显著降低总的CVD负担。然而,仍需要进一步研究,以准确估计它们作为风险和预后调节因素的影响程度,以便纳入未来的风险图表中。本综述对非传统危险因素、其病理生理机制及其对个性化医疗的影响进行了批判性分析。将这些因素纳入CVR评估可以重新划分患者的风险类别,优化治疗策略,并改善预后。然而,仍需要进一步研究,以完善它们在风险图表中的纳入情况,并评估它们对公共卫生结果的影响。采取量身定制的多学科方法对于减轻CVD负担和相关死亡率至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a92/12111945/cfb2d67e2790/jcdd-12-00171-g001.jpg

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