脂蛋白(a):急性ST段抬高型心肌梗死的潜在新靶点

Lipoprotein (a): A Potential New Target for Acute ST-Segment Elevation Myocardial Infarction

动脉粥样硬化性心血管疾病(Atherosclerotic Cardiovascular Disease, ASCVD)居全球心血管疾病(Cardiovascular Disease, CVD)首位,并成为当今全球人类死亡的首要原因,ST段抬高型心肌梗死(ST-segment Elevation Myocardial Infarction, STEMI)作为其最急性的临床表现,严重威胁人类的健康和生存质量。而血脂异常加速动脉粥样硬化(Atherosclerosis, AS)的形成,是ASCVD发生的核心机制。其中低密度脂蛋白胆固醇(Low-density Lipoproteins Cholesterol, LDL-C)作为重要的血脂指标,其水平控制在当今指南理想范围之内仍存在心血管事件(Cardiovascular Events, CVE)残余风险,这强调寻找新型潜在脂质生物标志物作为ASCVD发展风险预测因子的必要性。脂蛋白(a) [Lipoprotein a, Lp (a)]已被证明在AS中起因果作用,同时也是CVD患者中最佳降脂治疗后残余风险的主要贡献者。本综述旨在讲述Lp (a)致STEMI的发生机制,两者之间的相关性及治疗。

Atherosclerotic Cardiovascular Disease ranks first in the global cardiovascular disease. ST-segment elevation myocardial infarction as its most acute clinical manifestation is a serious threat to human health and quality of life. And dyslipidemia accelerates the formation of atherosclerosis, which is the core mechanism of the occurrence of atherosclerotic cardiovascular disease. Among them, LDL cholesterol as an important lipid index, still has residual risk of cardiovascular events within the ideal range of the current guidelines, which emphasizes the need to find novel potential lipid bi-omarkers as predictors of risk for the development of atherosclerotic cardiovascular disease. Lipo-protein (a) has been shown to play a causal role in atherosclerosis and is also a major contributor to residual risk after optimal lipid-lowering therapy in patients with cardiovascular disease world-wide. The purpose of this review is to describe the pathogenesis, correlation and treatment of ST-elevation myocardial infarction induced by lipoprotein (a).