کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
2998704 | 1180256 | 2013 | 18 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Lipoprotein(a), Cardiovascular Disease, and Contemporary Management
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کلمات کلیدی
CCHSHRTCHDLDL-CRCTHDL-CLp(a) - Lp (a)Randomized controlled trial - آزمایش تصادفی کنترل شدهapo - آپوapolipoprotein - آپولیپوپروتئینcoronary heart disease - بیماری عروق کرونر قلبCV disease - بیماری ویروسیCVD - رسوب دهی شیمیایی بخار cardiovascular - قلبی عروقیLipoprotein(a) - لیپوپروتئین (a)high-density lipoprotein cholesterol - لیپوپروتئین پرچگالی یا اچدیالLow-density lipoprotein - لیپوپروتئین کم چگالی یا الدیال LDL - لیپوپروتئین کم چگالی(کلسترول بد)Copenhagen City Heart Study - مطالعه قلب شهر کپنهاگAIM-HIGH - هدف بالاhormone replacement therapy - هورمون جایگزین درمانFamilial hypercholesterolemia - هیپرکلسترولمی فامیلیSingle-nucleotide polymorphism - پلی مورفیسم تک نوکلئوتیدیSNP - چندریختی تک-نوکلئوتیدLDL cholesterol - کلسترول LDL
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
چکیده انگلیسی
Elevated lipoprotein(a) (Lp[a]) is a causal genetic risk factor for cardiovascular disease. To determine if current evidence supports both screening and treatment for elevated Lp(a) in high-risk patients, an English-language search of PubMed and MEDLINE was conducted. In population studies, there is a continuous association between Lp(a) concentrations and cardiovascular risk, with synergistic effects when low-density lipoprotein (LDL) is also elevated. Candidates for Lp(a) screening include patients with a personal or family history of premature cardiovascular disease, familial hypercholesterolemia, recurrent cardiovascular events, or inadequate LDL cholesterol (LDL-C) responses to statins. Given the comparative strength of clinical evidence, reducing LDL-C to the lowest attainable value with a high-potency statin should be the primary focus of lipid-modifying therapies. If the Lp(a) level is 30 mg/dL or higher in a patient who has the aforementioned characteristics plus residual LDL-C elevations (â¥70-100 mg/dL) despite maximum-potency statins or combination statin therapy, the clinician may consider adding niacin (up to 2 g/d). If, after these interventions, the patient has progressive coronary heart disease (CHD) or LDL-C levels of 160-200 mg/dL or higher, LDL apheresis should be contemplated. Although Lp(a) is a major causal risk factor for CHD, no currently available controlled studies have suggested that lowering it through either pharmacotherapy or LDL apheresis specifically and significantly reduces coronary risk. Further research is needed to (1) optimize management in order to reduce CHD risk associated with elevated Lp(a) and (2) determine what other intermediate- or high-risk groups might benefit from Lp(a) screening.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Mayo Clinic Proceedings - Volume 88, Issue 11, November 2013, Pages 1294-1311
Journal: Mayo Clinic Proceedings - Volume 88, Issue 11, November 2013, Pages 1294-1311
نویسندگان
Terry A. MD,