Приложение на мултибиомаркерен подход при оценка на сърдечносъдовия риск в помощ на общопрактикуващия лекар
Ключови думи :
липопротеин (а), високочувствителен С-реактивен протеин, LDL холестерол, биомаркери, сърдечносъдов рискАбстракт
Резюме. Сърдечносъдовите заболявания (ССЗ) остават водеща причина за заболяемост и смъртност в световен мащаб – факт, поставящ значителни предизвикателства пред общопрактикуващите лекари в насока ранно идентифициране на рисковите пациенти и изготвяне на план за ефективна превенция. Въпреки широкото приложение на статини и съвременните липидопонижаващи стратегии значителен брой пациенти продължават да проявяват остатъчен сърдечносъдов риск. В този контекст нараства значението на някои допълнителни биомаркери, които биха могли да подпомогнат вземането на подходящо клинично решение в първичната помощ. Настоящият обзор акцентира върху три ключови биомаркера – LDL холестерол (LDL-C), липопротеин (а) (Lp(a) и високочувствителен С-реактивен протеин (hsCRP). Докато LDL-C остава основен терапевтичен прицел, Lp(a) е генетично детерминиран фактор с ограничен отговор към стандартната терапия, а hsCRP служи като надежден маркер за хронично нискостепенно възпаление и допълнителен рисков предиктор. Несъмнено тяхното комбинирано приложение в практиката на общопрактикуващите лекари би предоставило възможност за подобрение в стратификацията на риска, персонализирането на лечебния подход и превантивната ефективност при индивидите със или без установено ССЗ.
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