Ann Rheum Dis:他汀与强直性脊柱炎患者死亡风险降低相关?

2017-10-12 王淳 环球医学

2017年10月,发表在《Ann Rheum Dis》上的一项基于普通人群的队列研究,调查了强直性脊柱炎(AS)患者使用他汀的生存获益情况。研究结果表明:他汀使用与AS患者死亡风险显著降低相关,并且在普通人群的随机试验和类风湿关节炎患者的基于人群队列研究中,逆相关似乎更强。

2017年10月,发表在《Ann Rheum Dis》上的一项基于普通人群的队列研究,调查了强直性脊柱炎(AS)患者使用他汀的生存获益情况。研究结果表明:他汀使用与AS患者死亡风险显着降低相关,并且在普通人群的随机试验和类风湿关节炎患者的基于人群队列研究中,逆相关似乎更强。

目的:近期研究表明AS能增加心血管和全因死亡率。研究人员在一个普通人群背景下考察AS中他汀使用的潜在生存获益。

方法:研究人员使用2000年1月1日和2014年12月31日间UK普通人群数据库,开展了一项使用者队列研究,按时间分层并根据倾向性评分匹配。为考虑潜在的混淆因素,研究人员使用1年队列权责发生区组,比较按倾向性评分匹配的队列,他汀使用者和他汀不使用者。用于建立倾向性评分模型的变量包括疾病持续时间、体重指数、生活方式因素、并存病和药物使用。

结果:采用未匹配的AS队列,他汀使用者(n=1430)的死亡率风险比不使用者(n=1430)高43%(HR=1.43;95%CI 1.12-1.84)。按倾向性评分匹配后,使用他汀的AS患者(n=1108)中有96例死亡,而匹配的不使用者(n=1108)中有134例死亡,平均随访期分别为5.3和5.1折。相应的死亡率分别为16.5和23.8/患者-年(PY),HR是0.63(95%CI 0.46-0.85),绝对死亡率差值是7.3例死亡/1000PY(95%CI 2.1-12.5)。

结论:基于普通人群的队列研究证实他汀使用与AS患者死亡风险显着降低相关。在普通人群的随机试验和类风湿关节炎患者的基于人群队列研究中,逆相关似乎更强。

原始出处:

Oza A, Lu N, Schoenfeld SR,et al. Survival benefit of statin use in ankylosing spondylitis: a general population-based cohort study. Ann Rheum Dis. 2017 Oct;76(10):1737-1742. doi: 10.1136/annrheumdis-2017-211253. Epub 2017 Jul 11.

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    2018-07-06 zywlvao
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    2017-10-12 doctorJiangchao

    谢谢分享.

    0

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冠心病(CHD)是全球死亡的主要原因。他汀可预防已知心血管疾病或风险等同患者的CHD事件和死亡率,并预防无症状低危人群的CHD。2013 ACC/AHA指南已扩大他汀类使用范围的推荐,但是其成本效果还没有与其他指南进行过比较。2017年9月,《Circulation》的一项研究调查了冠心病和卒中初级预防中他汀使用指南的影响和成本效果。请看本期多学科讨论组临床药师各抒己见为您梳理本文看点——背景:他

中国头颈部动脉粥样硬化诊治共识:这三类人应该吃他汀

中国慢病前瞻性研究一项新的分析显示,中国有三分之一成人存在颈动脉粥样硬化斑块。对于颈动脉粥样硬化,该怎么办?

Gastroenterology:结肠癌确诊患者服用他汀能降低死亡风险

他汀使用与结肠癌发病率减少相关。2017年8月,发表在《Gastroenterology》上的一项研究显示,结肠癌确诊患者服用他汀能降低任何原因或癌症死亡风险。

美国医生关于脑卒中后使用他汀的思考:可能不是每个人都需要

在很多医院,脑卒中后他汀的使用已成为一种必做的事情。几乎所有诊断为脑卒中的患者都服用高剂量他汀。当我向医学领导询问这一指导方针时,他们的口头禅是,脑卒中后高剂量他汀的使用是基于证据的。未说出的信息已经很明确:用这种方法。