JAMA Inter Med:他汀类预防心血管疾病?到底“靠不靠谱”?

2017-05-23 sunshine2015 来宝网

根据一项新的研究,参加临床试验的老年患者的数据分析显示,当他汀类药物开始用于老年高血压和中等高胆固醇患者进行一级预防时,并未在所有原因死亡或冠心病事件预防中得到益处。

【老年人应用他汀类预防血管事件有没有益处?】根据一项新的研究,参加临床试验的老年患者的数据分析显示,当他汀类药物开始用于老年高血压和中等高胆固醇患者进行一级预防时,并未在所有原因死亡或冠心病事件预防中得到益处。

许多老年患者服用他汀类药物用于初级心血管预防,但数据仅限于该年龄组中用于一级预防的他汀类药物的风险和益处。提高对老年患者预防干预措施的理解对保健及其成本有影响。

纽约大学医学院的本杰明·汉,医学博士,即该研究共同作者分析了1994年到2002年进行降血压和降脂治疗的降脂试验(LLT)组成中老年人的数据。

作者使用了一个分析样本,其中包括2,867名高血压成人,但没有基线动脉粥样硬化性心血管疾病(动脉斑块积累)。在2,867名成年人中,有1,467名服用普伐他汀钠(每天40毫克),其中另外1400名只接受初级保健医师的一般护理。

作者报道,普伐他汀对冠心病二次事件、特殊原因死亡率以及全因死亡率的结果没有任何好处。成人65?74岁,成年人75岁以上,普伐他汀组死亡发生率均高于常规护理组(141例vs. 130例及92例 vs.65例)。根据结果,65-74岁人群中普伐他汀组中有76例心血管疾病事件,常规护理组89例。75岁以上人群中,普伐他汀组有 31例心血管疾病事件,常规护理组则为39例。两组治疗组的中风,心力衰竭和癌症发生率相似。

作者注意到目前研究的局限性,其中包括将其设计作为亚组患者的临床次要分析。

“他汀类药物被给予老年人作为初级预防没有发现任何益处,治疗建议应该为这个人群实现个体化治疗,”文章总结说。

原始出处:

Benjamin H. Han,David Sutin, Jeff D. Williamson, et al. Effect of Statin Treatment vs Usual Care on Primary Cardiovascular Prevention Among Older Adults. JAMA Intern Med. Published online May 22, 2017. doi:10.1001/jamainternmed.2017.1442.

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    2017-06-14 人生如书

    高龄老人服用他汀还是需要重点评估风险效益比吧?

    0

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    2017-05-26 lou.minghong

    学习

    0

  4. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue May 23 19:23:04 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-05-25 lcys98

    学习

    0

  5. 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  6. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Wed May 24 06:54:01 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201782, encodeId=355a201e82e6, content=任何药物都需要个体化, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Tue May 23 23:00:07 CST 2017, time=2017-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201744, encodeId=e1ca201e443b, content=好好学习努力学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue May 23 19:23:04 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-05-24 为啥子

    用于一级预防,成本是个问题啊

    0

  8. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Wed May 24 06:54:01 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201782, encodeId=355a201e82e6, content=任何药物都需要个体化, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Tue May 23 23:00:07 CST 2017, time=2017-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201744, encodeId=e1ca201e443b, content=好好学习努力学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue May 23 19:23:04 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-05-24 inter158

    他汀类药物被给予老年人作为初级预防没有发现任何益处,

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1756639, encodeId=7ec71e5663971, content=<a href='/topic/show?id=ba8e99e857c' target=_blank style='color:#2F92EE;'>#靠谱#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99785, encryptionId=ba8e99e857c, topicName=靠谱)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=199a37204836, createdName=ms117281293605716, createdTime=Sat Nov 11 09:00:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=210452, encodeId=8a9b21045279, content=高龄老人服用他汀还是需要重点评估风险效益比吧?, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuNib2ibCzAHhv9SZIn8nWA2GibA5kvJsTzl1vx602Pp56JWgq4pqfAGEwqqmRn9bMdCK52CU1XlN5Xx/0, 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Wed May 24 06:54:01 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201782, encodeId=355a201e82e6, content=任何药物都需要个体化, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Tue May 23 23:00:07 CST 2017, time=2017-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201744, encodeId=e1ca201e443b, content=好好学习努力学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue May 23 19:23:04 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-05-23 1ddf0692m34(暂无匿称)

    任何药物都需要个体化

    0

  10. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Wed May 24 06:54:01 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201782, encodeId=355a201e82e6, content=任何药物都需要个体化, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Tue May 23 23:00:07 CST 2017, time=2017-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201744, encodeId=e1ca201e443b, content=好好学习努力学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue May 23 19:23:04 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-05-23 忠诚向上

    好好学习努力学习

    0

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PLoS One:早期慢性肾病患者使用他汀类药物:利 or 弊?

血脂异常可能会加速CKD进展,使用他汀类药物有助于改善肾功能,但CKD 患者使用他汀类药物的适应证尚不十分明确。近日,韩国嘉泉大学(Gachon University)的Ji Yong Jung博士研究小组在 PLoS ONE 发表的研究表明,“早期慢性肾脏病(CKD)患者(1-3期,估计肾小球滤过率≥ 30 ml/min/1.73 m2)服用他汀类药物可延缓肾功能下降,降低全因死亡率。”该回顾性

他汀类药物治疗可降低AS+PsA患者的心血管风险和总死亡率

根据美国风湿病学会年会上提交的调查结果显示,使用他汀类药物可以让强直性脊柱炎+银屑病关节炎患者的死亡率下降32%。 Amar Oza博士和同事们对2904例强直性脊柱炎(AS)+银屑病关节炎(PsA)患者进行了研究,研究他汀类药物对这类患者的生存益处。 平均随访时间为5.3年,他汀类使用者中死亡人数为271例;对照组5.15年的随访期间内,死亡人数为376例。他汀类药物使用组的死亡率为

JAMA Cardiol:心脏病发作出院后高强度他汀类药物不能停

根据JAMA心脏病学杂志发表的一项研究,住院治疗心脏病后的患者被给予高强度他汀类药物,在出院后两年,大部分患者没有继续服用高剂量的该药物。

Chest:他汀类药物可降低结核病的发生风险!

由此可见,他汀类药物可降低结核病的发生风险。