JAMA:他汀类药物对高龄老年人动脉粥样硬化性心血管疾病一级预防有益

2020-07-08 MedSci原创 MedSci原创

研究认为,对于75岁以上且基线无动脉粥样硬化性心血管疾病的参与者,开始接受他汀类药物可降低动脉粥样硬化性心血管疾病风险

近日研究人员评估了他汀类药物对75岁及以上老年人动脉粥样硬化性血管疾病(ASCVD)的预防作用。
 
本次研究为回顾性队列研究,使用退伍军人健康管理局(VHA)数据对75岁及以上、无ASCVD的成年人进行研究,并在2002-2012年进行临床随访,分析参与者任何新的他汀类药物处方数据。研究的主要结果是全因死亡率和心血管死亡率,次要结果包括ASCVD事件(心肌梗死、缺血性卒中、冠状动脉旁路移植术或经皮冠状动脉介入治疗后的血运重建)。
 
326981名参与者,平均年龄81.1岁,97%为男性,91%为白人,57178名参与者(17.5%)首次使用他汀类药物。在平均6.8年的随访中,共发生206902例死亡,其中53296例心血管死亡,他汀类药物使用者和非他汀类药物使用者的死亡总数分别为78.7例/1000人-年和98.2例/1000人-年(加权发病率差[IRD]-19.5)。他汀类药物使用者和非他汀类药物使用者每1000人年心血管疾病死亡人数分别为22.6和25.7(加权IRD/1000人年:-3.1)。综合ASCVD事件总计123379起,他汀类药物使用者和非他汀类药物使用者分别为66.3和70.4起/1000人-年(加权IRD/1000人年:-4.1)。倾向评分显示,他汀类药物使用者与非使用者相比,全因死亡率的危险比为0.75,心血管死亡率的危险比为0.80,ASCVD事件的复合危险比为0.92。
 
研究认为,对于75岁以上且基线无动脉粥样硬化性心血管疾病的参与者,开始接受他汀类药物可降低动脉粥样硬化性心血管疾病风险。
 
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  4. 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09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498748, encodeId=ba311498e486b, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Jul 10 09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801794, encodeId=cb68801e947b, content=<a href='/topic/show?id=de4119403c2' target=_blank style='color:#2F92EE;'>#一级预防#</a>他汀类药物虽然可以去预防心脏疾病,但是他增加糖尿病的风险又怎么看呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19403, encryptionId=de4119403c2, topicName=一级预防)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Jul 08 23:42:22 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036160, encodeId=3f2510361608e, content=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, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jul 08 21:41:13 CST 2020, time=2020-07-08, status=1, ipAttribution=)]
  5. 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09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498748, encodeId=ba311498e486b, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Jul 10 09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801794, encodeId=cb68801e947b, content=<a href='/topic/show?id=de4119403c2' target=_blank style='color:#2F92EE;'>#一级预防#</a>他汀类药物虽然可以去预防心脏疾病,但是他增加糖尿病的风险又怎么看呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19403, encryptionId=de4119403c2, topicName=一级预防)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Jul 08 23:42:22 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036160, encodeId=3f2510361608e, content=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, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jul 08 21:41:13 CST 2020, time=2020-07-08, status=1, ipAttribution=)]
  6. 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09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498748, encodeId=ba311498e486b, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Jul 10 09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801794, encodeId=cb68801e947b, content=<a href='/topic/show?id=de4119403c2' target=_blank style='color:#2F92EE;'>#一级预防#</a>他汀类药物虽然可以去预防心脏疾病,但是他增加糖尿病的风险又怎么看呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19403, encryptionId=de4119403c2, topicName=一级预防)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Jul 08 23:42:22 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036160, encodeId=3f2510361608e, content=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, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jul 08 21:41:13 CST 2020, time=2020-07-08, status=1, ipAttribution=)]
    2020-07-10 xlysu
  7. 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09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498748, encodeId=ba311498e486b, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Jul 10 09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801794, encodeId=cb68801e947b, content=<a href='/topic/show?id=de4119403c2' target=_blank style='color:#2F92EE;'>#一级预防#</a>他汀类药物虽然可以去预防心脏疾病,但是他增加糖尿病的风险又怎么看呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19403, encryptionId=de4119403c2, topicName=一级预防)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Jul 08 23:42:22 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036160, encodeId=3f2510361608e, content=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, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jul 08 21:41:13 CST 2020, time=2020-07-08, status=1, ipAttribution=)]
  8. 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encryptionId=de4119403c2, topicName=一级预防)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Jul 08 23:42:22 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036160, encodeId=3f2510361608e, content=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, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jul 08 21:41:13 CST 2020, time=2020-07-08, status=1, ipAttribution=)]
  9. 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09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498748, encodeId=ba311498e486b, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Jul 10 09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801794, encodeId=cb68801e947b, content=<a href='/topic/show?id=de4119403c2' target=_blank style='color:#2F92EE;'>#一级预防#</a>他汀类药物虽然可以去预防心脏疾病,但是他增加糖尿病的风险又怎么看呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19403, encryptionId=de4119403c2, topicName=一级预防)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Jul 08 23:42:22 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036160, encodeId=3f2510361608e, content=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, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jul 08 21:41:13 CST 2020, time=2020-07-08, status=1, ipAttribution=)]
    2020-07-08 lovetcm

    #一级预防#他汀类药物虽然可以去预防心脏疾病,但是他增加糖尿病的风险又怎么看呢?

    0

  10. 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09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498748, encodeId=ba311498e486b, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Jul 10 09:41:13 CST 2020, time=2020-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801794, encodeId=cb68801e947b, content=<a href='/topic/show?id=de4119403c2' target=_blank style='color:#2F92EE;'>#一级预防#</a>他汀类药物虽然可以去预防心脏疾病,但是他增加糖尿病的风险又怎么看呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=155, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19403, encryptionId=de4119403c2, topicName=一级预防)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Wed Jul 08 23:42:22 CST 2020, time=2020-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036160, encodeId=3f2510361608e, content=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, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jul 08 21:41:13 CST 2020, time=2020-07-08, status=1, ipAttribution=)]
    2020-07-08 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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