秋水仙碱对脂蛋白(a)和氧化磷脂相关心血管疾病风险的影响

IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Niekbachsh Mohammadnia, Amber van Broekhoven, Willem A Bax, John W Eikelboom, Arend Mosterd, Aernoud T L Fiolet, Jan G P Tijssen, Peter L Thompson, Dominique P V de Kleijn, Sotirios Tsimikas, Jan H Cornel, Calvin Yeang, Saloua El Messaoudi
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引用次数: 0

摘要

目的:脂蛋白上的炎性脂蛋白(a)[Lp(a)]和氧化磷脂(OxPLs)传递着残留的心血管疾病风险。LoDoCo2(低剂量秋水仙碱 2)试验表明,秋水仙碱可降低慢性冠心病(CCS)患者接受标准疗法后发生心血管事件的风险。我们探讨了秋水仙碱对 LoDoCo2 生物标志物亚群中脂蛋白(a)和氧化脂蛋白相关风险的影响:在 LoDoCo2 试验的生物标志物人群(n = 1777)中测定脂蛋白(a)、脂蛋白(a)上的氧化脂蛋白[OxPL-apo(a)]和脂蛋白 B(OxPL-apoB)水平。采用 Cox 回归分析比较了生物标志物水平对主要终点(包括心肌梗死、缺血性中风或缺血性血运重建)的风险影响。评估了治疗、脂蛋白(a)和OxPL水平之间的相互作用:结果:秋水仙碱组和安慰剂组的脂蛋白(a)、OxPL-apo(a)和 OxPL-apoB 水平相似。结果:秋水仙碱组和安慰剂组的 Lp(a)和 OxPL-apo(a) 和 OxPL-apoB 水平相似:在 CCS 患者中,无论 Lp(a)是否升高,秋水仙碱都能降低心血管疾病风险,但 Lp(a)≥125 nmol/L 患者的绝对获益更高。OxPL-apoB水平较高的患者从秋水仙碱中获益更大,这表明秋水仙碱对氧化驱动炎症加剧的受试者可能更有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effects of Colchicine on Lipoprotein(a) and Oxidized Phospholipid Associated Cardiovascular Disease Risk.

Aims: Inflammatory lipoprotein(a) [Lp(a)] and oxidized phospholipids (OxPLs) on lipoproteins convey residual cardiovascular disease risk. The LoDoCo2 (low-dose colchicine 2) trial showed that colchicine reduced the risk for cardiovascular events occurring on standard therapies in patients with chronic coronary disease (CCS). We explored the effects of colchicine on Lp(a) and oxidized lipoprotein associated risk in a LoDoCo2 biomarker subpopulation.

Methods: Lp(a), OxPLs on apolipoprotein(a) [OxPL-apo(a)] and apolipoprotein B (OxPL-apoB) levels were determined in the biomarker population of the LoDoCo2 trial (n = 1777). Cox regression analysis was used to compare the risk for the primary endpoint, consisting of myocardial infarction, ischemic stroke, or ischemia-driven revascularization by biomarker levels. Interactions between treatment, Lp(a) and OxPL levels were evaluated.

Results: Lp(a), OxPL-apo(a) and OxPL-apoB levels were similar between the colchicine and placebo groups. Consistent risk reduction by colchicine was observed in those with Lp(a) <125 nmol/L and ≥125 nmol/L, and the highest OxPL-apo(a) tertile compared to the lowest (Pinteraction=0.92 and 0.66). The absolute risk reduction for those with Lp(a) ≥125 nmol/L appeared higher compared to those with Lp(a) <125 nmol/L (4.4% vs 2.4%). A treatment interaction for colchicine was found in those with the highest OxPL-apoB tertile vs the lowest (Pinteraction=0.04).

Conclusion: In patients with CCS, colchicine reduces cardiovascular disease risk in those with and without elevated Lp(a) but absolute benefits appeared higher in those with Lp(a) ≥125 nmol/L. Patients with higher levels of OxPL-apoB experienced greater benefit of colchicine, suggesting colchicine may be more effective in subjects with heightened oxidation-driven inflammation.

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来源期刊
European journal of preventive cardiology
European journal of preventive cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
12.50
自引率
12.00%
发文量
601
审稿时长
3-8 weeks
期刊介绍: European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.
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