JACC:依折麦布/辛伐他汀联合降脂治疗可提高ACS患者的临床疗效

2016-01-26 崔倩 译 MedSci原创

在IMPROVE-IT研究中(改进了减少的成果:Vytorin的功效国际试验),与安慰剂/辛伐他汀相比相比,依折麦布/辛伐他汀强化治疗急性冠状动脉综合征(ACS)患者低密度脂蛋白胆固醇显著降低患者的第一初级终点(PEP)。该分析测试假设总的事件,包括那些超出第一事件的事件,可通过依折麦布/辛伐他汀疗法减少。研究人员对所有PEP事件(随机化后心血管[CV]死亡,心肌梗死[MI],中风,不稳定型心绞痛

在IMPROVE-IT研究中(改进了减少的成果:Vytorin的功效国际试验),与安慰剂/辛伐他汀相比相比,依折麦布/辛伐他汀强化治疗急性冠状动脉综合征(ACS)患者低密度脂蛋白胆固醇显著降低患者的第一初级终点(PEP)。

该研究的分析验证了总的事件假设,包括那些超出第一终点的事件,可通过依折麦布/辛伐他汀疗法减少。

研究人员对所有PEP事件(随机化后心血管[CV]死亡,心肌梗死[MI],中风,不稳定型心绞痛[UA]导致住院,冠状动脉血运重建≥30天)在平均6年的随访过程中进行了分析,分析的患者包括在IMPROVE-IT中随机接受依折麦布/辛伐他汀或安慰剂/辛伐他汀的患者。负二项回归被用于初步分析。

在18,144例患者中,共有9,545例PEP事件(56%为第一事件,44%为后续事件)。依折麦布/辛伐他汀与安慰剂/辛伐他汀相比,总PEP事件显著降低9%(发病率比[RR]:0.91;95%可信区间(CI):0.85〜0.97; P=0.007),预先指定的二次复合终点和探索复合终点事件是心血管死亡、心肌梗死或卒中(RR:0.88; 95%CI:0.81〜0.96; p=0.002)。总事件数的减少,主要是因为总的非致死性心肌梗死(RR:0.87; 95%CI:0.79〜0.96; P=0.004)和总NF中风的减少(RR:;0.7795%CI:0.65〜0.93; P=0.005)。

依折麦布加辛伐他汀进行降脂治疗能够提高临床疗效。通过降低心肌梗死和中风从而降低总的PEP的事件,能阻止双倍甚至更多的事件。这些数据支持继续最初的心血管事件后强化联合降脂治疗。

原始出处:

Sabina A. Murphy,Christopher P. Cannon,Michael A. Blazing,et al.Reduction in Total Cardiovascular Events With Ezetimibe/Simvastatin Post-Acute Coronary Syndrome,JACC,2016.1.26

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    2016-10-30 hbwxf
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    2016-01-28 yaanren
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