Diabetes Obes Metab:高甘油三酯血症患者发生心血管事件的风险

2019-11-20 xing.T MedSci原创

由此可见,真实世界分析表明甘油三酸酯升高很常见,并且通常与心血管风险增加有关。在高甘油三酯血症患者中进行的心血管预后试验将阐明减少甘油三酸酯的策略是否可以改善服用他汀类药物患者的残留心血管风险。

尽管控制了低密度脂蛋白胆固醇,但接受他汀类药物治疗的患者仍有大量残留的心血管疾病风险。其他可改变的致动脉粥样硬化脂质和脂蛋白,例如甘油三酸酯和富含甘油三酸酯的脂蛋白,可能会导致一部分残留风险。近日,代谢内分泌疾病领域权威杂志Diabetes Obesity & Metabolism上发表了一篇研究文章,研究人员描述了现实中高甘油三酯血症的患病率和结局。

研究人员使用了大型患者数据库:NHANES(2007-2014)、Optum研究数据库和来自两个Kaiser Permanente地区的电子病历。

NHANES数据显示,美国约有26%的人群,包括近三分之一的他汀类药物使用者,存在临界高甘油三酯血症(甘油三酯≥150mg/dL),尽管使用他汀类药物,约40%糖尿病成年人,甘油三酸酯水平仍≥150mg/dL。Optum分析表明,使用他汀类药物治疗且甘油三酸酯≥150mg/dL的患者发生复合主要心血管事件的风险显著增加(相比于甘油三酸酯<150 mg/dL的患者,HR为1.26;95%CI为1.19-1.34;P<0.001)。这伴随着医疗保健利用率的提高和直接医疗保健成本的增加(HR为1.12;95%CI为1.08-1.16;P<0.001)。在Kaiser分析中,与甘油三酯<150 mg/dL的患者相比,甘油三酯为200-499mg/dL的糖尿病患者非致命性心肌梗死(比值比为1.30;95%CI为1.08-1.58;P=0.006)、非致命性卒中(1.23;1.01-1.49;P=0.037)和冠状动脉血运重建(1.21;1.02-1.43;P=0.027)调整后的发病率显著增加,不稳定型心绞痛则不然(1.33;0.87-2.03;P=0.185)。

由此可见,真实世界分析表明甘油三酸酯升高很常见,并且通常与心血管风险增加有关。在高甘油三酯血症患者中进行的心血管预后试验将阐明减少甘油三酸酯的策略是否可以改善服用他汀类药物患者的残留心血管风险。 

原始出处:

Peter P. Toth.et al.Risk of Cardiovascular Events in Patients with Hypertriglyceridemia: A Review of Real‐World Evidence.Diabetes Obesity & Metabolism.2019. https://publons.com/publon/10.1111/dom.13921

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    2020-05-12 guojianrong
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    2020-06-24 一闲
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