{"id":254319,"date":"2025-01-21T22:28:30","date_gmt":"2025-01-21T21:28:30","guid":{"rendered":"https:\/\/r3i.org\/%e3%83%95%e3%82%a9%e3%83%bc%e3%82%ab%e3%82%b9-%e6%80%a5%e6%80%a7%e5%86%a0%e7%97%87%e5%80%99%e7%be%a4%e6%82%a3%e8%80%85%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e3%83%aa%e3%83%9d%e8%9b%8b%e7%99%bda\/"},"modified":"2025-02-16T22:17:39","modified_gmt":"2025-02-16T21:17:39","slug":"%e3%83%95%e3%82%a9%e3%83%bc%e3%82%ab%e3%82%b9-%e6%80%a5%e6%80%a7%e5%86%a0%e7%97%87%e5%80%99%e7%be%a4%e6%82%a3%e8%80%85%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e3%83%aa%e3%83%9d%e8%9b%8b%e7%99%bda","status":"publish","type":"page","link":"https:\/\/r3i.org\/ja\/%e3%83%95%e3%82%a9%e3%83%bc%e3%82%ab%e3%82%b9-%e6%80%a5%e6%80%a7%e5%86%a0%e7%97%87%e5%80%99%e7%be%a4%e6%82%a3%e8%80%85%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e3%83%aa%e3%83%9d%e8%9b%8b%e7%99%bda\/","title":{"rendered":"\u30d5\u30a9\u30fc\u30ab\u30b9 – \u6025\u6027\u51a0\u75c7\u5019\u7fa4\u60a3\u8005\u306b\u304a\u3051\u308b\u30ea\u30dd\u86cb\u767d(a)\u4e0a\u6607\u3068\u51a0\u52d5\u8108\u30ea\u30b9\u30af"},"content":{"rendered":"\n[et_pb_section fb_built=”1″ _builder_version=”4.27.4″ _module_preset=”default” custom_padding=”1px|||||” global_colors_info=”{}”][et_pb_row _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.27.4″ _module_preset=”default” header_2_text_color=”gcid-primary-color” header_5_text_color=”gcid-secondary-color” text_orientation=”center” width=”99%” custom_margin=”|-147px||||” custom_padding=”|0px||||” hover_enabled=”0″ global_colors_info=”{%22gcid-primary-color%22:%91%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22header_2_text_color%22%93,%22gcid-secondary-color%22:%91%22header_5_text_color%22%93}” sticky_enabled=”0″]

\u30d5\u30a9\u30fc\u30ab\u30b9 –\u6025\u6027\u51a0\u75c7\u5019\u7fa4\u60a3\u8005\u306b\u304a\u3051\u308b\u30ea\u30dd\u86cb\u767d(a)\u4e0a\u6607\u3068\u51a0\u52d5\u8108\u30ea\u30b9\u30af<\/span><\/h2>\n
2024\u5e741\u67088\u65e5<\/span><\/h5>\n

\u51a0\u52d5\u8108\u75be\u60a3\u3068\u30ea\u30dd\u86cb\u767d(a)[Lp(a)] \u306e\u9ad8\u5024\u3092\u6709\u3059\u308b\u60a3\u8005\u3092\u5bfe\u8c61\u3068\u3057\u305f\u3053\u306e\u89b3\u5bdf\u7814\u7a76\u306f\u3001\u73fe\u5728\u9032\u884c\u4e2d\u306eOlpasiran Trials of Cardiovascular Events and Lipoprotein(a) Reduction[OCEAN(a)]-Outcomes trial\u306e\u767b\u9332\u96c6\u56e3\u3068\u4e00\u81f4\u3057\u3066\u304a\u308a\u3001\u8cb4\u91cd\u306a\u77e5\u898b\u3092\u63d0\u4f9b\u3057\u3066\u3044\u308b\u3002<\/em><\/p>\n

Shiyovich A, Berman AN, Besser SA, et al. \u51a0\u52d5\u8108\u75be\u60a3\u3068\u30ea\u30dd\u86cb\u767d(a)\u4e0a\u6607\u3092\u6709\u3059\u308b\u60a3\u8005\u306b\u304a\u3051\u308b\u5fc3\u8840\u7ba1\u30a2\u30a6\u30c8\u30ab\u30e0\uff1aOCEAN(a)-outcomes\u8a66\u9a13\u96c6\u56e3\u3078\u306e\u793a\u5506\u3002Eur Heart J Open 2023;3, 1-4. <\/em><\/p>\n

\u7814\u7a76\u6982\u8981<\/b><\/p>\n\n\n\n\n\n\n\n
\u76ee\u7684<\/strong><\/td>\nOCEAN(a)-Outcomes\u8a66\u9a13\u306e\u4e3b\u767b\u9332\u57fa\u6e96\u306b\u985e\u4f3c\u3057\u305f\u89b3\u5bdf\u30b3\u30db\u30fc\u30c8\u306b\u304a\u3044\u3066\u3001Lp(a)\u6fc3\u5ea6\u4e0a\u6607\u3068\u5fc3\u8840\u7ba1\u8ee2\u5e30\u3068\u306e\u95a2\u9023\u3092\u8a55\u4fa1\u3059\u308b\u3053\u3068\u3002<\/td>\n<\/tr>\n
\u7814\u7a76\u30c7\u30b6\u30a4\u30f3\uff1a<\/strong><\/td>\n\u5927\u898f\u6a21\u306a\u30ec\u30c8\u30ed\u30b9\u30da\u30af\u30c6\u30a3\u30d6Lp(a)\u30ec\u30b8\u30b9\u30c8\u30ea\u304b\u3089\u5f97\u3089\u308c\u305f\u89b3\u5bdf\u30b3\u30db\u30fc\u30c8\uff082000\u5e74\u304b\u30892019\u5e74\u306e\u9593\u306b\u60a3\u8005\u3092\u767b\u9332\uff09\u3002<\/td>\n<\/tr>\n
\u7814\u7a76\u5bfe\u8c61\u8005\uff1a<\/strong><\/td>\n\u5fc3\u7b4b\u6897\u585e\uff08MI\uff09\u307e\u305f\u306f\u7d4c\u76ae\u7684\u51a0\u52d5\u8108\u30a4\u30f3\u30bf\u30fc\u30d9\u30f3\u30b7\u30e7\u30f3\uff08PCI\uff09\u306e\u65e2\u5f80\u306e\u3042\u308b\u60a3\u80053,142\u4f8b\uff08\u5e74\u9f62\u4e2d\u592e\u502461\u6b73\u3001\u5973\u602729\uff05\uff09\u3092\u5bfe\u8c61\u3068\u3057\u305f\u3002\u91cd\u5ea6\u306e\u814e\u6a5f\u80fd\u969c\u5bb3\u307e\u305f\u306f\u60aa\u6027\u65b0\u751f\u7269\u3092\u6709\u3059\u308b\u60a3\u8005\u306f\u9664\u5916\u3055\u308c\u305f\u3002 <\/td>\n<\/tr>\n
\u4e3b\u8981\u8a55\u4fa1\u9805\u76ee<\/strong><\/td>\n\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u51a0\u52d5\u8108\u6027\u5fc3\u75be\u60a3\uff08CHD\uff09\u306b\u3088\u308b\u6b7b\u4ea1\u3001\u5fc3\u7b4b\u6897\u585e\uff08MI\uff09\u3001\u51a0\u52d5\u8108\u8840\u884c\u518d\u5efa\u8853\u306e\u8907\u5408\u3068\u3057\u305f\u3002<\/td>\n<\/tr>\n
\u65b9\u6cd5\uff1a<\/strong><\/td>\nLp(a)\u306e\u4e0a\u6607\u306fOCEAN(a)-Outcomes\u8a66\u9a13\u306b\u4e00\u81f4\u3057\u3066200nmol\/L\u4ee5\u4e0a\u3068\u5b9a\u7fa9\u3055\u308c\u305f\u3002Kaplan-Meier\u751f\u5b58\u66f2\u7dda\u306flog-rank\u691c\u5b9a\u3092\u7528\u3044\u3066\u6bd4\u8f03\u3057\u305f\u3002Cox\u6bd4\u4f8b\u30cf\u30b6\u30fc\u30c9\u56de\u5e30\u3092\u7528\u3044\u3066\u3001\u5fc3\u8840\u7ba1\u8ee2\u5e30\u306b\u304a\u3051\u308bLp(a)\u7fa4\uff08Lp(a)\u4e0a\u6607\u306e\u6709\u7121\uff09\u306e\u95a2\u9023\u3092\u8a55\u4fa1\u3057\u305f\u3002 <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u7d50\u679c
<\/strong><\/p>\n

\u5168\u4f53\u3068\u3057\u3066\u3001\u30b3\u30db\u30fc\u30c8\u306e12.3\uff05\u304cLp(a)\u6fc3\u5ea6\u306e\u4e0a\u6607\u3092\u8a8d\u3081\u305f\u3002\u3053\u308c\u3089\u306e\u60a3\u8005\u306f\u3001Lp(a)<200nmol\/L\u306e\u60a3\u8005\u3068\u6bd4\u8f03\u3057\u3066\u3001\u5973\u6027\uff0837.6\uff05\u5bfe27.3\uff05\uff09\u3067\u3042\u308a\u3001\u9ad8\u8102\u8840\u75c7\u3067\u3042\u308b\u50be\u5411\u304c\u5f37\u304b\u3063\u305f\u3002\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u502412.2\u5e74\u9593\u3067\u3001\u4e3b\u8981\u8907\u5408\u8ee2\u5e30\u306fLp(a)\u4e0a\u6607\u306e\u3042\u308b\u60a3\u8005\u3068\u306a\u3044\u60a3\u8005\u3067\u306f\u3001Lp(a)\u4e0a\u6607\u306e\u3042\u308b\u60a3\u8005\u306e\u65b9\u304c\u9ad8\u983b\u5ea6\u306b\u307f\u3089\u308c\u305f\uff0846.0\uff05\u5bfe38.0\uff05\u3001\u88681\uff09\u3002 <\/p>\n

\u88681 <\/span><\/strong>Lp(a)\u2267200 vs.<200nmol\/L\u306b\u95a2\u9023\u3059\u308b\u5fc3\u8840\u7ba1\u8ee2\u5e30\u306e\u30cf\u30b6\u30fc\u30c9\u6bd4\u3002 CI \u4fe1\u983c\u533a\u9593<\/p>\n\n\n\n\n\n\n\n
\n

\u53ef\u5909<\/strong><\/p>\n<\/td>\n

\n

\u672a\u8abf\u6574\u30cf\u30b6\u30fc\u30c9\u6bd4\uff0895\uff05CI\uff09<\/strong><\/p>\n<\/td>\n

\n

p\u5024<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

\u4e3b\u8981\u8a55\u4fa1\u9805\u76ee<\/p>\n<\/td>\n

\n

1.30 (1.09-1.53)<\/p>\n<\/td>\n

\n

0.003<\/p>\n<\/td>\n<\/tr>\n

\n

CHD\u6b7b\u4ea1<\/p>\n<\/td>\n

\n

1.40 (1.07-1.83)<\/p>\n<\/td>\n

\n

0.013<\/p>\n<\/td>\n<\/tr>\n

\n

MI<\/p>\n<\/td>\n

\n

1.41 (1.12-1.78)<\/p>\n<\/td>\n

\n

0.004<\/p>\n<\/td>\n<\/tr>\n

\n

\u51a0\u52d5\u8108\u8840\u884c\u518d\u5efa\u8853<\/p>\n<\/td>\n

\n

1.40 (1.13-1.72)<\/p>\n<\/td>\n

\n

0.002<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Lp(a)\u306e\u4e0a\u6607\u306f\u3001\u5e74\u9f62\u3001\u6027\u5225\u3001\u9ad8\u8840\u5727\u3001\u9ad8\u8102\u8840\u75c7\u3001\u7cd6\u5c3f\u75c5\u3001\u6162\u6027\u814e\u81d3\u75c5\u3001\u55ab\u7159\u3067\u8abf\u6574\u3057\u305f\u5f8c\u3082\u3001\u4e3b\u8981\u8ee2\u5e30\u3068\u72ec\u7acb\u3057\u3066\u95a2\u9023\u3057\u3066\u3044\u305f\uff08\u30cf\u30b6\u30fc\u30c9\u6bd41.33\u300195\uff05CI 1.12-1.58\uff09\u3001p = 0.001\uff09\u3002<\/span><\/p>\n

 <\/p>\n\n\n\n
\u8457\u8005\u306e\u7d50\u8ad6<\/strong><\/td>\nOCEAN(a)-Outcomes Trial\u306e\u767b\u9332\u57fa\u6e96\u306b\u985e\u4f3c\u3057\u305f\u89b3\u5bdf\u30b3\u30db\u30fc\u30c8\u306b\u304a\u3044\u3066\uff0cLp(a)\u304c200nmol\/L\u4ee5\u4e0a\u306e\u60a3\u8005\u306f\u5fc3\u8840\u7ba1\u8ee2\u5e30\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u304b\u3063\u305f\u3002<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\n

\u30b3\u30e1\u30f3\u30c8<\/strong><\/p>\n

Lp(a)\u306f\u5fc3\u8840\u7ba1\u8ee2\u5e30\u306e\u539f\u56e0\u7684\u5371\u967a\u56e0\u5b50\u3067\u3042\u308a\u3001\u9ad8\u30ea\u30b9\u30af\u60a3\u8005\u306b\u304a\u3051\u308b\u5fc3\u8840\u7ba1\u30ea\u30b9\u30af\u306e\u6b8b\u5b58\u306e\u4e00\u56e0\u3067\u3042\u308b\u3053\u3068\u3092\u652f\u6301\u3059\u308b\u591a\u304f\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u3042\u308b(1)\u3002\u3057\u304b\u3057\u306a\u304c\u3089\u3001Lp(a)\u6fc3\u5ea6\u4e0a\u6607\u306e\u540c\u5b9a\u3068\u7ba1\u7406\u306f\u3001\u6709\u52b9\u3067\u7279\u7570\u7684\u306a\u6cbb\u7642\u6cd5\u306e\u6b20\u5982\u306b\u60a9\u307e\u3055\u308c\u3066\u3044\u308b\u3002\u30a2\u30dd\u30ea\u30dd\u86cb\u767d\uff08a\uff09[apo(a)] \u306e\u5408\u6210\u3092\u6a19\u7684\u3068\u3059\u308b\u65b0\u3057\u3044RNA\u30a2\u30d7\u30ed\u30fc\u30c1\u306f\u3001\u6709\u52b9\u3067\u5fcd\u5bb9\u6027\u304c\u9ad8\u3044\u3053\u3068\u304c\u793a\u3055\u308c\u3066\u3044\u308b(2-4)\u304c\u3001Lp(a)\u6fc3\u5ea6\u306e\u4f4e\u4e0b\u304c\u5fc3\u8840\u7ba1\u7cfb\u306e\u8ee2\u5e30\u306e\u6e1b\u5c11\u306b\u3064\u306a\u304c\u308b\u304b\u3069\u3046\u304b\u306f\u307e\u3060\u4e0d\u660e\u3067\u3042\u308b\u3002\u3053\u306e\u7591\u554f\u3092\u89e3\u6c7a\u3059\u308b\u305f\u3081\u306e\u8a66\u9a13\u304c\u73fe\u5728\u9032\u884c\u4e2d\u3067\u3042\u308b\u3002\u305d\u306e\u4e00\u3064\u306f\u3001\u30aa\u30eb\u30d1\u30b7\u30e9\u30f3\u3092\u7528\u3044\u305fOCEAN(a)-Outcomes\u8a66\u9a13\u3067\u3042\u308b(5)\u3002 <\/p>\n

\u4eca\u56de\u306e\u5831\u544a\u3067\u306f\u3001OCEAN(a)-Outcomes\u8a66\u9a13\u3068\u540c\u3058\u4e3b\u8981\u7d44\u307f\u5165\u308c\u57fa\u6e96\u3092\u7528\u3044\u3066\u3001\u8cea\u306e\u9ad8\u3044Lp(a)\u30ec\u30b8\u30b9\u30c8\u30ea\u306e\u89b3\u5bdf\u30b3\u30db\u30fc\u30c8\u306b\u304a\u3044\u3066\u3001Lp(a)\u4e0a\u6607\u3068\u5fc3\u8840\u7ba1\u8ee2\u5e30\u3068\u306e\u95a2\u9023\u3092\u8a55\u4fa1\u3059\u308b\u3053\u3068\u3092\u76ee\u7684\u3068\u3057\u305f\u3002\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u306fCHD\u6b7b\u4ea1\u3001MI\u3001\u51a0\u52d5\u8108\u8840\u884c\u518d\u5efa\u8853\u306e\u8907\u5408\u3067\u3042\u3063\u305f\u3002\u672c\u8a66\u9a13\u306e\u7d50\u679c\u3001Lp(a)\u306e\u4e0a\u6607\u306f\u3001\u30b9\u30bf\u30c1\u30f3\uff08\u30b3\u30db\u30fc\u30c8\u306e90\uff05\uff09\u3084\u4ed6\u306e\u8102\u8cea\u4f4e\u4e0b\u7642\u6cd5\u3092\u53d7\u3051\u3066\u3044\u308b\u3059\u3067\u306b\u9ad8\u30ea\u30b9\u30af\u306e\u60a3\u8005\u306b\u304a\u3044\u3066\u3001\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u306e\u30ea\u30b9\u30af\u3092\u5897\u52a0\u3055\u305b\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u305f\uff08Lp(a)\u5024\u304c\u4e0a\u6607\u3057\u305f\u60a3\u8005\u3067\u306f24.9\uff05\u3001\u4e0a\u6607\u3057\u306a\u304b\u3063\u305f\u60a3\u8005\u3067\u306f14.9\uff05\uff09\u3002\u3053\u306e\u95a2\u9023\u306f\u8907\u6570\u306e\u4ea4\u7d61\u56e0\u5b50\u3067\u8abf\u6574\u3057\u305f\u5f8c\u3082\u6301\u7d9a\u3057\u305f\u3002\u3053\u306e\u6240\u898b\u306f\u3001Lp(a)\u306e\u4e0a\u6607\u304c\u78ba\u7acb\u3057\u305f\u5fc3\u8840\u7ba1\u75be\u60a3\u60a3\u8005\u306e\u4e88\u5f8c\u3092\u60aa\u5316\u3055\u305b\u308b\u3068\u3044\u3046\u4ed6\u306e\u5831\u544a\u3068\u4e00\u81f4\u3057\u3066\u3044\u308b(1,6)\u3002 <\/p>\n

\u5f8c\u65b9\u8996\u7684\u30c7\u30b6\u30a4\u30f3\u3068\u9078\u629e\u30d0\u30a4\u30a2\u30b9\u306e\u53ef\u80fd\u6027\u306f\u3042\u308b\u3082\u306e\u306e\u3001\u672c\u7814\u7a76\u306e\u7d50\u679c\u306fOCEAN(a)-Outcomes\u8a66\u9a13\u306e\u9078\u629e\u57fa\u6e96\u3092\u652f\u6301\u3059\u308b\u3082\u306e\u3067\u3042\u308b\u3002\u91cd\u8981\u306a\u3053\u3068\u306f\u3001\u3053\u306e\u7d50\u679c\u304c\u3001\u3053\u306e\u975e\u5e38\u306b\u30ea\u30b9\u30af\u306e\u9ad8\u3044\u60a3\u8005\u96c6\u56e3\u306b\u304a\u3051\u308bLp(a)\u5024\u4e0a\u6607\u306e\u540c\u5b9a\u3068\u6cbb\u7642\u306e\u7dca\u6025\u306e\u5fc5\u8981\u6027\u3092\u5f37\u8abf\u3057\u3066\u3044\u308b\u3053\u3068\u3067\u3042\u308b\u3002 <\/p>\n<\/div>\n\n\n\n\n
\u53c2\u8003\u6587\u732e<\/strong><\/td>\n1.Kronenberg F, Mora S, Stroes ESG, et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement.Eur Heart J 2022;43:3925-46\u3002
2.Tsimikas S, Karwatowska-Prokopczuk E, Gouni-Berthold I, et al. Lipoprotein(a) reduction in persons with cardiovascular disease.N Engl J Med 2020;382:244-55.
3.O’Donoghue ML, Rosenson RS, Gencer B, et al; OCEAN(a)-DOSE Trial Investigators.\u5fc3\u8840\u7ba1\u75be\u60a3\u306b\u304a\u3051\u308b\u30ea\u30dd\u86cb\u767d(a)\u3092\u6e1b\u5c11\u3055\u305b\u308b\u5c0f\u5e72\u6e09RNA\u3002N Engl J Med 2022;387:1855-64.
4.NissenSE\u3001Wolski K\u3001Balog C\u3001et al. \u8840\u6f3f\u4e2d\u306e\u30ea\u30dd\u86cb\u767d(a)\u6fc3\u5ea6\u304c\u9ad8\u3044\u4eba\u3092\u5bfe\u8c61\u3068\u3057\u305f\u3001\u30ea\u30dd\u86cb\u767d(a)\u7523\u751f\u3092\u6a19\u7684\u3068\u3059\u308b\u77ed\u9396\u5e72\u6e09RNA\u306e\u5358\u56de\u4e0a\u884c\u7528\u91cf\u8a66\u9a13\u3002
5.Olpasiran Trials of Cardiovascular Events and Lipoprotein(a) Reduction (OCEAN(a)) – Outcomes Trial (ClinicalTrials.gov Identifier: NCT05581303).
6. O’Donoghue ML, Fazio S, Giugliano RP, et al. Lipoprotein(a), PCSK9 inhibition, and cardiovascular risk.Circulation 2019;139:1483-92. <\/td>\n<\/tr>\n
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