EHJCP:他汀治疗可降低无阻塞性CAD的糖尿病患者的主要不良心血管事件风险,但阿司匹林不能!

2021-05-15 Nebula MedSci原创

对于无阻塞性CAD的糖尿病患者,阿司匹林治疗既不能降低MACE风险,也不会增加出血风险

冠状动脉造影(CAG)评估的没有阻塞性冠状动脉疾病(CAD)的糖尿病患者常接受阿司匹林和他汀类药物治疗,但阿司匹林和他汀类药物治疗对这类患者人群预后的影响尚无完全明确。

本研究旨在评估阿司匹林和他汀药物治疗对无阻塞性CAD的糖尿病患者的血管和出血事件的影响。

纳入了于2003年-2016年在西丹麦接受CAG评估的无阻塞性CAD的糖尿病患者。根据在CAG后6个月内有无服用阿司匹林和他汀药物治疗将患者进行了分层,分别进行了分析。主要预后是MACE(主要不良心血管事件心肌梗死、缺血性卒中和死亡的复合结果)和出血(只对比阿司匹林的影响)。为了避免混淆因素的干扰,研究人员采用了基于倾向得分的权重来估计治疗加权风险比的反概率(HRIPTW)。

总体上,本分析共纳入了4124位患糖尿病但无CAD的受试者,其中2474位(60%)在CAG后6个月内接受阿司匹林治疗,2916位(71%)采用他汀药物治疗。

不同治疗对10年MACE和全因死亡风险的影响

中位随访4.9年。与未接受他汀治疗的受试者相比,他汀治疗可降低MACE(25% vs 37%,HRIPTW 0.58, 95% CI 0.48-0.70)

与未采用阿司匹林治疗的受试者相比,阿司匹林治疗不能降低这类受试人群的10年MACE(21.3% vs 21.8%,HRIPTW 1.01,95% CI 0.82-1.25)、全因死亡率(HRIPTW 0.96, 95% CI 0.74-1.23)或出血风险(HRIPTW 0.95, 95% CI 0.73-1.23)。

总而言之,对于无阻塞性CAD的糖尿病患者,阿司匹林治疗既不能降低MACE风险,也不会增加出血风险。相反,他汀药物治疗可降低这类患者人群的MACE风险

原始出处:

Olesen Kevin K W,Heide-J?rgensen Uffe,Thim Troels et al. Statin but not Aspirin Treatment is Associated with Reduced Cardiovascular Risk in Patients with Diabetes without Obstructive Coronary Artery Disease.[J] .Eur Heart J Cardiovasc Pharmacother, 2021, https://doi.org/10.1093/ehjcvp/pvab040

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    2021-06-14 tomyang96
  6. [GetPortalCommentsPageByObjectIdResponse(id=1643745, encodeId=c4431643e45af, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Sun Aug 15 23:22:48 CST 2021, time=2021-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1287707, encodeId=2cbe128e7072c, content=<a href='/topic/show?id=3c3d51e4459' target=_blank style='color:#2F92EE;'>#心血管事件风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51744, encryptionId=3c3d51e4459, topicName=心血管事件风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3138208, createdName=zhanfl, createdTime=Mon May 17 11:22:48 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1475070, encodeId=dee814e507010, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Mon May 17 11:22:48 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1533205, encodeId=1a791533205be, content=<a href='/topic/show?id=c7a02326657' target=_blank style='color:#2F92EE;'>#主要不良心血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23266, encryptionId=c7a02326657, topicName=主要不良心血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=929a12392280, createdName=wetgdt, createdTime=Mon May 17 11:22:48 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1696976, encodeId=7d3f16969e617, content=<a href='/topic/show?id=d2e99e651e4' target=_blank style='color:#2F92EE;'>#阻塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97651, encryptionId=d2e99e651e4, topicName=阻塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a23129903429, createdName=tomyang96, createdTime=Mon Jun 14 20:22:48 CST 2021, time=2021-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965964, encodeId=2b4b9659643c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb3b5421831, createdName=ms8000000638284823, createdTime=Sun May 16 06:21:49 CST 2021, time=2021-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043606, encodeId=1f7a104360670, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat May 15 23:22:48 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965903, encodeId=28369659039e, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sat May 15 21:07:23 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965894, encodeId=04259658943d, content=挺好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71695502309, createdName=ms4000000212072525, createdTime=Sat May 15 20:33:46 CST 2021, time=2021-05-15, status=1, ipAttribution=)]
    2021-05-16 ms8000000638284823

    学习了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1643745, encodeId=c4431643e45af, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Sun Aug 15 23:22:48 CST 2021, time=2021-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1287707, encodeId=2cbe128e7072c, content=<a href='/topic/show?id=3c3d51e4459' target=_blank style='color:#2F92EE;'>#心血管事件风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51744, encryptionId=3c3d51e4459, topicName=心血管事件风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3138208, createdName=zhanfl, createdTime=Mon May 17 11:22:48 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1475070, encodeId=dee814e507010, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Mon May 17 11:22:48 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1533205, encodeId=1a791533205be, content=<a href='/topic/show?id=c7a02326657' target=_blank style='color:#2F92EE;'>#主要不良心血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23266, encryptionId=c7a02326657, topicName=主要不良心血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=929a12392280, createdName=wetgdt, createdTime=Mon May 17 11:22:48 CST 2021, time=2021-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1696976, encodeId=7d3f16969e617, content=<a href='/topic/show?id=d2e99e651e4' target=_blank style='color:#2F92EE;'>#阻塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97651, encryptionId=d2e99e651e4, topicName=阻塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a23129903429, createdName=tomyang96, createdTime=Mon Jun 14 20:22:48 CST 2021, time=2021-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965964, encodeId=2b4b9659643c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cb3b5421831, createdName=ms8000000638284823, createdTime=Sun May 16 06:21:49 CST 2021, time=2021-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043606, encodeId=1f7a104360670, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat May 15 23:22:48 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965903, encodeId=28369659039e, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sat May 15 21:07:23 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=965894, encodeId=04259658943d, content=挺好的, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71695502309, createdName=ms4000000212072525, createdTime=Sat May 15 20:33:46 CST 2021, time=2021-05-15, status=1, ipAttribution=)]
    2021-05-15 misszhang

    谢谢MedSci提供最新的资讯

    0

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    2021-05-15 wxl882001

    了解

    0

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    2021-05-15 ms4000000212072525

    挺好的

    0

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