NEJM:心血管疾病伴痛风患者应慎用非布索坦

2018-03-13 zhangfan MedSci原创

研究认为对于存在心血管疾病的痛风患者,服用非布索坦或别嘌呤醇对患者心血管不良事件的影响差异不显著,但非布索坦导致患者全因死亡以及心血管死亡风险增加

痛风患者的心血管风险增加。近日研究人员比较了非嘌呤类黄嘌呤氧化酶抑制剂--非布索坦和嘌呤类黄嘌呤氧化酶抑制剂--别嘌呤醇对痛风患者心血管事件的影响。

患有心血管疾病的痛风患者参与研究,随机接受非布索坦或别嘌呤醇,依据肾功能进行分层。主要终点为心血管死亡、非致命性心肌梗死、非致命性中风、不稳定型心绞痛并伴有急性血管重建的复合终点,定义非劣性边界为终点事件风险比值比1.3以内。

6190名患者参与研究,平均随访32个月,56.6%的患者终止了试验方案,45.0%的患者未完成随访。意向分析中,非布索坦组335人(10.8%)出现终点事件,别嘌呤醇组321人(10.4%)出现终点事件(HR 1.03)。非布索坦组的全因死亡率和心血管死亡率均高于别嘌呤醇组(全因死亡HR 1.22;心血管死亡HR 1.34)。

研究认为对于存在心血管疾病的痛风患者,服用非布索坦或别嘌呤醇对患者心血管不良事件的影响差异不显著,但非布索坦导致患者全因死亡以及心血管死亡风险增加。

原始出处:

William B. White et al. Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout. N Engl J Med. March 12, 2018.

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1700906, encodeId=9da01e0090659, content=<a href='/topic/show?id=7605993983e' target=_blank style='color:#2F92EE;'>#非布索坦#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99398, encryptionId=7605993983e, topicName=非布索坦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=968830287714, createdName=wetgdt, createdTime=Sat Nov 24 09:44:00 CST 2018, time=2018-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498384, encodeId=4a2d149838456, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Mar 15 04:44:00 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296128, encodeId=118a29612833, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Mar 14 09:04:58 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295868, encodeId=b794295868ed, content=好好努力.继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue Mar 13 15:21:31 CST 2018, time=2018-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295846, encodeId=fcdf29584618, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Tue Mar 13 14:07:39 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1700906, encodeId=9da01e0090659, content=<a href='/topic/show?id=7605993983e' target=_blank style='color:#2F92EE;'>#非布索坦#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99398, encryptionId=7605993983e, topicName=非布索坦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=968830287714, createdName=wetgdt, createdTime=Sat Nov 24 09:44:00 CST 2018, time=2018-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498384, encodeId=4a2d149838456, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Mar 15 04:44:00 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296128, encodeId=118a29612833, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Mar 14 09:04:58 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295868, encodeId=b794295868ed, content=好好努力.继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue Mar 13 15:21:31 CST 2018, time=2018-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295846, encodeId=fcdf29584618, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Tue Mar 13 14:07:39 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
    2018-03-14 明月清辉

    谢谢分享.学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1700906, encodeId=9da01e0090659, content=<a href='/topic/show?id=7605993983e' target=_blank style='color:#2F92EE;'>#非布索坦#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99398, encryptionId=7605993983e, topicName=非布索坦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=968830287714, createdName=wetgdt, createdTime=Sat Nov 24 09:44:00 CST 2018, time=2018-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498384, encodeId=4a2d149838456, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Mar 15 04:44:00 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296128, encodeId=118a29612833, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Mar 14 09:04:58 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295868, encodeId=b794295868ed, content=好好努力.继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue Mar 13 15:21:31 CST 2018, time=2018-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295846, encodeId=fcdf29584618, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Tue Mar 13 14:07:39 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
    2018-03-13 忠诚向上

    好好努力.继续学习

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1700906, encodeId=9da01e0090659, content=<a href='/topic/show?id=7605993983e' target=_blank style='color:#2F92EE;'>#非布索坦#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99398, encryptionId=7605993983e, topicName=非布索坦)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=968830287714, createdName=wetgdt, createdTime=Sat Nov 24 09:44:00 CST 2018, time=2018-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498384, encodeId=4a2d149838456, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Mar 15 04:44:00 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296128, encodeId=118a29612833, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Mar 14 09:04:58 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295868, encodeId=b794295868ed, content=好好努力.继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue Mar 13 15:21:31 CST 2018, time=2018-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295846, encodeId=fcdf29584618, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Tue Mar 13 14:07:39 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
    2018-03-13 yfjms

    学习

    0

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