Lancet:基线以及他汀药物治疗后脂蛋白水平对心血管事件的预测作用

2018-10-08 zhangfan MedSci原创

研究证实,脂蛋白水平是反映心血管风险的重要因素,他汀类药物具有明确的降低高脂人群心血管风险的作用

一般人群中,脂蛋白升高是重要的血管疾病遗传危险因素,但其在血管疾病患者接受他汀类药物治疗后对心血管风险的预测效果尚不确定。

研究人员对7个随机、安慰剂对照、他汀类药物的试验结果进行汇总,根据患者脂蛋白水平,将患者分为4组:<15 mg/dL 、15-30 mg/dL、30-50mg/dL以及≥50 mg/dL,以计算心血管事件的危险比(HRS),定义心血管事件包括致命或非致命性冠心病、中风或血管再灌注。

总计29069名患者参与研究,平均年龄62岁,女性占28%,在95576个患者随访年中发生5751例终点事件。接受他汀类药物治疗可显著降低患者低密度胆固醇含量(平均减少39%),但对于总脂蛋白含量影响不显著。基线以及他汀类药物治疗后脂蛋白含量与心血管疾病风险关系大致是线性的,基线脂蛋白含量30 mg/dL以上以及治疗后50 mg/dL以上患者的心血管事件风险显著增加。调整年龄和性别后,与基线脂蛋白含量<15 mg/dL的患者相比,15-30mg/dL、30-50mg/dL 以及50 mg/dL以上人群的心血管风险分别为1.04、1.11以及1.31,接受药物治疗后分别为0.94、1.06以及1.43。他汀类药物治疗对心血管事件降低作用显著优于安慰剂,在低龄人群的效果尤为显著。

研究证实,脂蛋白水平是反映心血管风险的重要因素,他汀类药物具有明确的降低高脂人群心血管风险的作用。

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    2019-08-09 howi
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    2018-11-16 jyzxjiangqin

    他汀药物引起的不良反应。

    0

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    2018-10-15 jyzxjiangqin

    他汀药物治疗进展。

    0

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    2018-10-15 jyzxjiangqin

    他汀药物治疗进展。

    0

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  7. [GetPortalCommentsPageByObjectIdResponse(id=1643573, encodeId=ac0316435e3bb, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Sun Aug 11 01:55:00 CST 2019, time=2019-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829831, encodeId=6a7a1829831fc, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri Aug 09 08:55:00 CST 2019, time=2019-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=352783, encodeId=be09352e836c, content=他汀药物引起的不良反应。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Fri Nov 16 20:01:44 CST 2018, time=2018-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349440, encodeId=175534944038, content=他汀药物治疗进展。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Mon Oct 15 20:40:43 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349441, encodeId=44da34944187, content=他汀药物治疗进展。, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Mon Oct 15 20:40:29 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1424719, encodeId=cedb1424e1981, content=<a href='/topic/show?id=5a3b8441438' target=_blank style='color:#2F92EE;'>#脂蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84414, encryptionId=5a3b8441438, topicName=脂蛋白)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=23ea3924919, createdName=juliusluan79, createdTime=Wed Oct 10 02:55:00 CST 2018, time=2018-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348559, encodeId=0d28348559c6, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Tue Oct 09 00:25:23 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348481, encodeId=628634848189, content=认真学习,不断进步,把经验分享给同好。点赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eb131638261, createdName=lietome24, createdTime=Mon Oct 08 12:26:00 CST 2018, time=2018-10-08, status=1, ipAttribution=)]
    2018-10-09 smartxiuxiu

    0

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    2018-10-08 lietome24

    认真学习,不断进步,把经验分享给同好。点赞了!

    0

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Expert Re Clin Phar :“放弃”他汀类药物有了新证据

近日,来自美国、爱尔兰、意大利、瑞典、法国和日本等国的17位医生发表的一篇综述文章称,胆固醇或“坏”胆固醇水平高与心脏病无关,并要求医生“放弃”使用他汀类药物。

冠脉钙化评分或可在一定程度上决定是否使用他汀

在7月27日~29日举行的美国预防心脏病学会2018年会中公布的一项报告表明,使用冠状动脉钙化(CAC)评分有助于更好的决定是否进行他汀治疗。

Eur Heart J:长期应用他汀 有无必要担心不良反应

他汀是临床上应用非常普遍的一类降脂药物,目前大量文献资料均证实和肯定了他汀的降脂疗效和心血管获益。但任何药物都是“双刃剑”,有治疗效果就有不良反应,他汀也不能幸免。长期服用他汀有哪些不良反应呢?这些不良反应是否会抵消其心脑血管获益?我们又该如何看待和理解他汀的心脑血管获益与不良反应呢?

Neurology:他汀具有预防脑出血的作用?

心血管病危险因素会增加缺血性卒中和脑出血(ICH)的风险。HMG-CO还原酶抑制剂(他汀)是一种降脂药物,广泛应用于血管病的一级和二级预防之中。然而,人们关注他汀是否会增加ICH的风险。

Clin Gastroenterol H:平时服用他汀 凶残的胰腺癌来临时能有一线生机?

胰腺癌被称为“癌中之王”,并不是浪得虚名,死亡率高达99%。美国作家埃德加·斯诺、《人鬼情未了》的男主角帕特里克、歌王帕瓦罗蒂、原国务院副总理黄菊、九段棋手陈祖德等,这些大家所熟知的大人物,尽管声名显赫,也拥有优越的医疗条件,最后也都还是没能从胰腺癌的魔爪下觅得生机。

JAHA:他汀类药物可改善腹主动脉瘤患者预后

目前,腹主动脉瘤(AAA)没有特效的药物治疗,尽管有研究显示他汀类药物对AAA有益处。本荟萃分析的目的旨在评估他汀类药物对AAA的生长、破裂和30天死亡率的影响。本次荟萃分析纳入分析了911篇临床文章,包括1个病例对照研究和21个队列研究,共计80428例患者。分析结果显示,他汀类药物的使用与AAA生长率减少0.82 mm/y呈相关性(95% Cl 0.33- 1.32,P=0.001, I2=8