Atherosclerosis:维生素D能否改善他汀治疗的依从性和持续性?

2018-04-25 张琪 环球医学网

长期使用他汀会增加生存率。但是,其依从性和持续性是一种挑战,并会影响他汀治疗的成功与否。2018年4月,发表在《Atherosclerosis》的一项随机、双盲、安慰剂对照ViDA研究的二次分析调查了维生素D补充对长期他汀治疗依从性和持续性的影响。

长期使用他汀会增加生存率。但是,其依从性和持续性是一种挑战,并会影响他汀治疗的成功与否。2018年4月,发表在《Atherosclerosis》的一项随机、双盲、安慰剂对照ViDA研究的二次分析调查了维生素D补充对长期他汀治疗依从性和持续性的影响。

目的:研究人员旨在探讨每月补充维生素D(100000IU)是否会改善老年人长期使用他汀的依从性和持续性。

方法:研究人员进行了一项试验的二次分析,该试验比较了维生素D补充或安慰剂组患者的他汀处方调配数据。首要结局指标为所有他汀治疗的24个月测量期间的依从性(处方覆盖天数比例≥80%)和持续性(允许重新处方之间30天的时间窗后他汀治疗不停)。次要结局指标为所有类型他汀和各个他汀的其他测量期间的依从性和持续性。

结果:总体来说,2494名参与者在随访期接受长期他汀治疗(维生素D组1243例,安慰剂组1251例)。与安慰剂相比,每月补充维生素D不会改善依从性的比例(风险比,1.01;P=0.62),但是可改善24个月后服用所有他汀的持续性概率(风险比,1.15;P=0.02)。进一步研究发现,一线他汀治疗药物辛伐他汀的依从性存在显着性差异。

结论:每月补充维生素D可改善长期他汀治疗的老年人24个月测量期间服用他汀的持续性,尤其是辛伐他汀治疗者。长期他汀治疗的患者中,维生素D补充作为辅助治疗的作用需要进一步调查。

原始出处:
Zhenqiang Wu, Carlos A. Camargo Jr., Kay-Tee Khaw,et al.Effects of vitamin D supplementation on adherence to and persistence with long-term statin therapy: Secondary analysis from the randomized, double-blind, placebo-controlled ViDA study.June 2018Volume 273, Pages 59–66.DOI: https://doi.org/10.1016/j.atherosclerosis.2018.04.009

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    2018-04-27 fyxzlh
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    2018-04-27 lsndxfj
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    2018-04-25 sunfeifeiyang

    0

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