Am J Med:烟酸能升高HDL-C,但不能降低心脏事件风险

2016-11-11 MedSci MedSci原创

烟酸,可有效提高HDL-C,或许能够减少动脉粥样硬化性心血管疾病患者或高危人群的心脏事件。然而,既往近期的两项大型随机对照试验,在他汀类药物治疗背景下,比较烟酸和安慰剂,却没有得出积极效果。 根据现有证据,我们研究了当前实践中,烟酸治疗降低心血管事件风险的作用。 在MEDLINE、EMBASE、CINAHL和Cochrane数据库中检索比较单独烟酸治疗或烟酸联合他汀类药物治疗的随机对照

烟酸,可有效提高HDL-C(高密度脂蛋白),或许能够减少动脉粥样硬化性心血管疾病患者或高危人群的心脏事件。然而,既往近期的两项大型随机对照试验,在他汀类药物治疗背景下,比较烟酸和安慰剂,却没有得出积极效果。

根据现有证据,我们研究了当前实践中,烟酸治疗降低心血管事件风险的作用。

在MEDLINE、EMBASE、CINAHL和Cochrane数据库中检索比较单独烟酸治疗或烟酸联合他汀类药物治疗的随机对照临床试验,进行荟萃分析。

共有13项试验(n = 35206)纳入最终分析。平均随访时间为32.8个月。总的来说,烟酸导致血清HDL胆固醇水平的显著升高,从基线算起,升高21.4%, 9.31 [95% CI 5.11, 13.51] mg/dl。

但是研究者没有发现烟酸组和对照组的全因死亡率差异[RR 0.99; 95% CI 0.88-1.12]。

与对照组相比,烟酸有降低以下事件风险的趋势,但是均没有统计学意义:心血管死亡[RR 0.91; 95% CI 0.81-1.02]、冠心病死亡[RR 0.93; 95% CI 0.78- 1.10]、非致命性心肌梗死[RR 0.85; 95% CI 0.73-1.0]、血管重建术(冠状动脉和非冠状动脉)[RR 0.83; 95% CI 0.65-1.06]和卒中[RR 0.89; 95% CI 0.72-1.10]。

荟萃分析结果表明,烟酸治疗不能减少动脉粥样硬化性心血管疾病患者或高危人群的心脏事件。

原始出处:

Garg A, Sharma A,et al. Role of Niacin in current clinical practice: A systematic review. Am J Med. 2016 Oct 25.

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    2016-11-13 ZGMFX24A
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    2016-11-13 zblhy
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