Circulation:依泽替米贝联合他汀药物能明显降低ACS患者卒中风险

2017-10-01 MedSci MedSci原创

急性冠脉综合征(ACS)患者发生缺血性事件包括卒中的风险较高,依泽替米贝联合他汀类药物治疗能改善ACS后患者的心血管预后。本研究纳入了IMPROVE-IT临床研究中的对象,将发生ACS后的患者随机分成安慰剂联合辛伐他汀治疗组和依泽替米贝联合辛伐他汀治疗组,随访时间为6年。最终,本研究共纳入18144名ACS患者,641名(3.5%)患者经历过至少一次卒中事件,大部分为缺血性(82%)。卒中的独立预

急性冠脉综合征(ACS)患者发生缺血性事件包括卒中的风险较高,依泽替米贝联合他汀类药物治疗能改善ACS后患者的心血管预后。

本研究纳入了IMPROVE-IT临床研究中的对象,将发生ACS后的患者随机分成安慰剂联合辛伐他汀治疗组和依泽替米贝联合辛伐他汀治疗组,随访时间为6年。最终,本研究共纳入18144名ACS患者,641名(3.5%)患者经历过至少一次卒中事件,大部分为缺血性(82%)。卒中的独立预测因子包括既往卒中史、高龄、房颤、充血性心衰糖尿病、心梗和肾功能不全。与安慰剂组的患者相比,依泽替米贝联合辛伐他汀治疗组患者的卒中首次发生风险没有差异(4.2% vs 4.8%; HR 0.86, 0.73-1.00; p=0.052),但是缺血性卒中的发生率减少了21%(3.4% vs 4.1%; HR 0.79, 0.67-0.94; p=0.008),出血性卒中的发生风险没有差异(0.8% vs 0.6%; HR 1.38, 0.93-2.04; p=0.11)。若将所有的发生事件均考虑在内,依泽替米贝联合辛伐他汀治疗能明显降低任何病因来源的卒中(HR 0.83, 0.70-0.98; p=0.029)和缺血性卒中的发生风险(HR 0.76, 0.63-0.91; p=0.003)。此外,有既往卒中史的患者复发的风险更高,对于这些患者,依泽替米贝联合辛伐他汀治疗同样能明显降低任何病因来源的卒中(10.2% vs 18.8%; NNT=12; HR 0.60, 0.38-0.95; p=0.030)和缺血性卒中的发生风险(8.7% vs 16.3%; NNT=13; HR 0.52, 0.31-0.86; p=0.011)。

研究结果显示,依泽替米贝联合辛伐他汀治疗能明显降低急性冠脉综合征患者卒中的发生风险。

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    2017-10-05 大爰

    学习了谢谢分享!!

    0

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    2017-10-03 yaanren
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    2017-10-01 lovetcm

    NNT=13.表明这种保护作用是非常明显.也说明这种方案对于心血管的风险的减少非常有价值

    0

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超声心动图可以作为风湿性心脏病(RHD)有力的筛查工具。近日,在国际心血管权威杂志Circulation上发表了一篇旨在评估儿童潜在风湿性心脏病的长期预后和相关风险因素的临床研究。本研究纳入了227例有潜在RHD的儿童(164处于边界范围,63例确诊),并对其随访1年以上,所有纳入对象的超声心动图均由心脏专家进行回顾评估。所有对象的平均年龄为12岁,平均随访时间是2.3年(IQR 2.0-2.9)

CIRC RES:微小RNA可作为急性缺血性卒中的生物标志物

目前,急性缺血性卒中(IS)尚无有效的血液生物标志物。微小RNA(micro RNAs)因为其细胞特异性和外周血稳定性被认为是疾病的良好生物标志物。 本研究通过RNA测序对20例IS患者和20例配对对照进行循环血液中微小RNA变化的检测,并经过半定量PCR技术对另一个独立样本(40例IS患者和40例配对对照)进行结果验证,在200例IS患者和200例配对对照中进行重复验证。最终,本研究筛选、