Circulation: 普伐他汀对预防冠心病死亡长期有效(16年随访的LIPID试验)

2016-04-09 MedSci MedSci原创

背景:研究者进行缺血性疾病长期普伐他汀干预试验(LIPID),旨在评估长期他汀类药物治疗对全因死亡率,特定原因死亡率及癌症的发病率的影响。方法:LIPID试验最初比较存在9014例冠状动脉粥样硬化性心脏病(CHD)患者,应用普伐他汀和安慰剂治疗6年。双盲期后,所有患者均进行开放性的他汀类药物治疗治疗。7721名患者继续研究10年,直接接触两年,之后进行问卷调查,从死亡和癌症登记处获得死亡和癌症相关

背景:研究者进行缺血性疾病长期普伐他汀干预试验(LIPID),旨在评估长期他汀类药物治疗对全因死亡率,特定原因死亡率及癌症的发病率的影响。

方法:LIPID试验最初比较存在9014例冠状动脉粥样硬化性心脏病(CHD)患者,应用普伐他汀和安慰剂治疗6年。双盲期后,所有患者均进行开放性的他汀类药物治疗治疗。7721名患者继续研究10年,直接接触两年,之后进行问卷调查,从死亡和癌症登记处获得死亡和癌症相关的数据。

结果:延长随访期间,85%分配进行普伐他汀治疗,84%分配安慰剂代替他汀治疗。普伐他汀治疗的患者,因CHD死亡(RR 0.89,95% CI 0.81-0.97 P P=0.009),心血管疾病死亡(RR 0.88,95% CI 0.81-0.95 P =0.002),任何原因的死亡风险(RR 0.91,95% CI 0.85-0.97绝对风险减少2.6 %,P = 0.003)均下降。双盲阶段(RR 0.94,95% CI 0.82-1.08,P = 0.41),随访阶段(RR 1.02;95% CI 0.91-1.14,P = 0.74)及整个阶段(RR 0.99;95% CI 0.91-1.08,P = 0.83),最初治疗组的癌症的发病率是相似的。癌症的死亡率,特定器官癌症的发生率没有显著差异。在延长随访中,其他大型的他汀类试验相关的meta分析也证实了癌症的研究结果。

结论:在LIPID试验中,6年的普伐他汀治疗的绝对生存获益可延长至未来10年,初始阶段后,两组幸存者死亡风险相似。长期随访中,他汀类治疗不影响癌症的发生和非心血管事件的死亡。

原文出处:

Hague WE, Simes J, et al. Long-Term Effectiveness and Safety of Pravastatin in Patients With Coronary Heart Disease: 16 Years of Follow-Up of the LIPID Study. Circulation. 2016 Mar 25.

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1945587, encodeId=cf40194558e5c, content=<a href='/topic/show?id=97c6599160e' target=_blank style='color:#2F92EE;'>#普伐他汀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59916, encryptionId=97c6599160e, topicName=普伐他汀)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd18451, createdName=xre2008, createdTime=Fri Nov 04 17:03:00 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656378, encodeId=ba3a16563e817, content=<a href='/topic/show?id=6e6a1091e1e' target=_blank style='color:#2F92EE;'>#Lipid#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10917, encryptionId=6e6a1091e1e, topicName=Lipid)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66a524807292, createdName=bettycmoon, createdTime=Sun Aug 07 22:03:00 CST 2016, time=2016-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78115, encodeId=2a52e8115f7, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:31:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78116, encodeId=6cd1e81160f, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:31:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76671, encodeId=6a5ce6671a4, content=谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73801651090, createdName=1ddc978cm67(暂无匿称), createdTime=Sun Apr 10 13:50:00 CST 2016, time=2016-04-10, status=1, ipAttribution=)]
    2016-08-07 bettycmoon
  3. [GetPortalCommentsPageByObjectIdResponse(id=1945587, encodeId=cf40194558e5c, content=<a href='/topic/show?id=97c6599160e' target=_blank style='color:#2F92EE;'>#普伐他汀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59916, encryptionId=97c6599160e, topicName=普伐他汀)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd18451, createdName=xre2008, createdTime=Fri Nov 04 17:03:00 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656378, encodeId=ba3a16563e817, content=<a href='/topic/show?id=6e6a1091e1e' target=_blank style='color:#2F92EE;'>#Lipid#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10917, encryptionId=6e6a1091e1e, topicName=Lipid)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66a524807292, createdName=bettycmoon, createdTime=Sun Aug 07 22:03:00 CST 2016, time=2016-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78115, encodeId=2a52e8115f7, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:31:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78116, encodeId=6cd1e81160f, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:31:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76671, encodeId=6a5ce6671a4, content=谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73801651090, createdName=1ddc978cm67(暂无匿称), createdTime=Sun Apr 10 13:50:00 CST 2016, time=2016-04-10, status=1, ipAttribution=)]
    2016-04-14 李继凯

    文章不错

    0

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    2016-04-14 李继凯

    值得学习

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1945587, encodeId=cf40194558e5c, content=<a href='/topic/show?id=97c6599160e' target=_blank style='color:#2F92EE;'>#普伐他汀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59916, encryptionId=97c6599160e, topicName=普伐他汀)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd18451, createdName=xre2008, createdTime=Fri Nov 04 17:03:00 CST 2016, time=2016-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656378, encodeId=ba3a16563e817, content=<a href='/topic/show?id=6e6a1091e1e' target=_blank style='color:#2F92EE;'>#Lipid#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10917, encryptionId=6e6a1091e1e, topicName=Lipid)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66a524807292, createdName=bettycmoon, createdTime=Sun Aug 07 22:03:00 CST 2016, time=2016-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78115, encodeId=2a52e8115f7, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:31:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78116, encodeId=6cd1e81160f, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:31:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76671, encodeId=6a5ce6671a4, content=谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73801651090, createdName=1ddc978cm67(暂无匿称), createdTime=Sun Apr 10 13:50:00 CST 2016, time=2016-04-10, status=1, ipAttribution=)]
    2016-04-10 1ddc978cm67(暂无匿称)

    谢谢分享。

    0

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