NEJM:缺血性发作患者降脂与后续心血管事件风险

2020-01-02 MedSci MedSci原创

研究认为,在缺血性或动脉粥样硬化性缺血性卒中患者中,接受目标LDL胆固醇水平低于每分升70mg降脂治疗患者的心血管事件风险更低

在短暂性脑缺血(TIA)和动脉粥样硬化性缺血性卒中患者中,推荐使用他汀类药物进行强化降脂治疗,但低密度脂蛋白(LD L)胆固醇水平对脑卒中后心血管事件的影响研究尚不充分。

这项在法国和韩国进行的平行试验中,研究人员招募3个月内的缺血性脑卒中患者或15天内TIA患者随机接受目标LDL胆固醇水平低于70毫克/分升(低目标组)或目标范围为90毫克至110毫克/分升(高目标组)的降脂治疗。所有患者都有脑血管或冠状动脉硬化的迹象,并接受他汀类,依泽替米贝或两者兼用。研究的主要终点为主要心血管复合事件,包括缺血性卒中、心肌梗死、导致紧急冠状动脉或颈动脉血管重建的新症状或心血管原因引起的死亡。

2860名患者参与研究,随访3.5年,各组1430名患者。基线时的平均LDL胆固醇水平为每分升135毫克,低目标组达到每分升65毫克,高目标组达到每分升96毫克。共发生277起终点事件,其中低目标组121例(8.5%),高目标组156例(10.9%,调整后的危险比为0.78)。两组颅内出血和新诊断糖尿病的发生率差异不显著。

研究认为,在缺血性或动脉粥样硬化性缺血性卒中患者中,接受目标LDL胆固醇水平低于每分升70mg降脂治疗患者的心血管事件风险更低。

原始出处:

Pierre Amarenco et al. A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke. N Engl J Med, January 2, 2020.

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    2020-01-02 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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