JASN:肾功能降低患者依折麦布加入辛伐他汀治疗的临床效益!

2017-05-18 xing.T MedSci原创

在稳定的急性冠脉综合征个体发病10天内,在eGFR中度降低的个体中(30-60毫升/每分钟/1.73平方米)联合治疗似乎比单药治疗更有效。但仍需要进一步研究来评估CKD个体采用联合降脂治疗潜在的好处。

慢性肾脏病(CKD)个人以他汀类药物为基础的治疗在降低心血管死亡率方面的疗效似乎随着eGFR下降而降低。依折麦布加入辛伐他汀与安慰剂治疗表明了最有力的证据支持CKD个人他汀类药物的心血管获益。然而,是否是联合治疗,还是单独他汀类药物治疗导致心血管获益仍不确定。

近日,肾脏病领域权威杂志Journal of the American Society of Nephrology上发表一篇研究文章,研究人员估计了来自于心血管疾病和肌酐清除率>30毫升/分钟的个体采用依折麦布加辛伐他汀和辛伐他汀单独治疗研究(IMPROVE-IT研究)的18015名个人肾小球滤过率(eGFR),并对治疗组间eGFR和终点之间关系进行了事后评估。

对于心血管死亡的主要终点,主要的冠状动脉事件,或非致命性卒中,联合治疗与单药治疗相比相对风险的降低随eGFR有所不同(P=0.04)。在eGFR≤75毫升/每分钟/1.73平方米的个体中可以观察到两种治疗方案存在差异,在eGFR≤60毫升/每分钟/1.73平方米个体中最明显。与接受单药治疗的个人相比,接受联合治疗的基础eGFR≤60毫升/每分钟/1.73平方米的个体风险降低了12%(风险比[HR]为0.88;95%可信区间[95%CI]为0.82-0.95);在基础eGFR≤45毫升/每分钟/1.73平方米的个体风险降低了13%(HR为0.87;95%CI为0.78-0.98)。

在稳定的急性冠脉综合征个体发病10天内,在eGFR中度降低的个体中(30-60毫升/每分钟/1.73平方米)联合治疗似乎比单药治疗更有效。但仍需要进一步研究来评估CKD个体采用联合降脂治疗潜在的好处。

原始出处:


John W. Stanifer,et al. Benefit of Ezetimibe Added to Simvastatin in Reduced Kidney Function. JASN, 2017, http://jasn.asnjournals.org/content/early/2017/05/12/ASN.2016090957.abstract

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    2018-04-06 chenhongpeng
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    2017-09-26 yese
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1941314, encodeId=2e911941314de, content=<a href='/topic/show?id=bd2f28e0e1' target=_blank style='color:#2F92EE;'>#ASN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2870, encryptionId=bd2f28e0e1, topicName=ASN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Fri Apr 06 01:55:00 CST 2018, time=2018-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1850608, encodeId=c4d3185060833, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, 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style='color:#2F92EE;'>#辛伐他汀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93844, encryptionId=f2fd938442c, topicName=辛伐他汀)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6fc262, createdName=zhangmingxiang, createdTime=Sat May 20 05:55:00 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1531033, encodeId=56d315310338d, content=<a href='/topic/show?id=f70f26896f8' target=_blank style='color:#2F92EE;'>#依折麦布#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26896, encryptionId=f70f26896f8, topicName=依折麦布)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f68912191404, createdName=zhu_jun9841, createdTime=Sat May 20 05:55:00 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=199760, encodeId=25fc199e6001, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Fri May 19 01:19:55 CST 2017, time=2017-05-19, status=1, ipAttribution=)]
    2017-06-20 jyzxjiangqin

    肾功能降低患者的治疗。

    0

  5. 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GetPortalCommentsPageByObjectIdResponse(id=199760, encodeId=25fc199e6001, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Fri May 19 01:19:55 CST 2017, time=2017-05-19, status=1, ipAttribution=)]
    2017-06-08 jyzxjiangqin

    关注他汀治疗后肾功能的变化。

    0

  6. 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GetPortalCommentsPageByObjectIdResponse(id=199760, encodeId=25fc199e6001, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Fri May 19 01:19:55 CST 2017, time=2017-05-19, status=1, ipAttribution=)]
    2017-05-30 收获你的美

    学习了谢谢分享

    0

  7. 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    2017-05-24 jyzxjiangqin

    肾功能降低患者降脂治疗。

    0

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    2017-05-19 tanxingdoctor

    学习啦谢谢分享

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