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Lancet:他汀类药物在心血管事件一级预防中的作用无性别差异

2015-01-11 MedSci MedSci原创

研究背景: 他汀类药物治疗在女性中的心血管事件一级预防作用是否与男性一致,一直备受争议。研究人员在胆固醇治疗研究者协作组(Cholesterol Treatment Trialists' (CTT) Collaboration)数据库,对他汀类药物的临床试验进行了荟萃分析,即在于比较他汀类药物在男性和女性人群中的疗效。 研究方法: 研究人员供收集27项他汀类药物临床试验数据,其中

研究背景: 他汀类药物治疗在女性中的心血管事件一级预防作用是否与男性一致,一直备受争议。研究人员在胆固醇治疗研究者协作组(Cholesterol Treatment Trialists' (CTT) Collaboration)数据库,对他汀类药物的临床试验进行了荟萃分析,即在于比较他汀类药物在男性和女性人群中的疗效。 研究方法: 研究人员供收集27项他汀类药物临床试验数据,其中22项临床试验设有他汀类药物治疗组和安慰剂组(n=134 537),5项临床试验设有高强度的他汀类药物治疗组和低强度的他汀类药物治疗组(n=39 612)。研究人员采用非性别差异矫正的Cox回归模型,评估了每1.0 mmol/L的LDL胆固醇下降权重对重要的血管事件、重要的冠脉事件、中风、冠脉血流重建和死亡率的影响,并在男性和女性人群中评估药物疗效差异。对于亚组分析,研究人员采用99%可信区间进行多重比较。 研究结果: 随机招募的174149名受试者中,46675名(27%)为女性。在为期1年的血脂监测中,他汀类药物的疗效在男性和女性之间无差异(他汀类药物治疗组的LDL胆固醇浓度与安慰剂组相比下降1·1 mmo

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2044361, encodeId=4647204436110, content=<a href='/topic/show?id=644725344b1' target=_blank style='color:#2F92EE;'>#他汀类药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25344, encryptionId=644725344b1, topicName=他汀类药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Sun May 31 21:17:00 CST 2015, time=2015-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643354, encodeId=f5b11643354d8, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Thu Jul 23 18:17:00 CST 2015, time=2015-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1827969, encodeId=8d12182e96953, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Jan 31 11:17:00 CST 2015, time=2015-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14277, encodeId=db83142e7cf, content=他汀仍然有一定保护作用, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=175.9.205.**, createdTime=Tue Jan 13 22:27:00 CST 2015, time=2015-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14269, encodeId=a699142697a, content=有必要再按不同年龄段进行亚组分析, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=lovetcm, createdTime=Tue Jan 13 21:50:00 CST 2015, time=2015-01-13, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2044361, encodeId=4647204436110, content=<a href='/topic/show?id=644725344b1' target=_blank style='color:#2F92EE;'>#他汀类药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25344, encryptionId=644725344b1, topicName=他汀类药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Sun May 31 21:17:00 CST 2015, time=2015-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643354, encodeId=f5b11643354d8, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Thu Jul 23 18:17:00 CST 2015, time=2015-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1827969, encodeId=8d12182e96953, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Jan 31 11:17:00 CST 2015, time=2015-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14277, encodeId=db83142e7cf, content=他汀仍然有一定保护作用, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=175.9.205.**, createdTime=Tue Jan 13 22:27:00 CST 2015, time=2015-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14269, encodeId=a699142697a, content=有必要再按不同年龄段进行亚组分析, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=lovetcm, createdTime=Tue Jan 13 21:50:00 CST 2015, time=2015-01-13, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2044361, encodeId=4647204436110, content=<a href='/topic/show?id=644725344b1' target=_blank style='color:#2F92EE;'>#他汀类药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25344, encryptionId=644725344b1, topicName=他汀类药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Sun May 31 21:17:00 CST 2015, time=2015-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643354, encodeId=f5b11643354d8, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Thu Jul 23 18:17:00 CST 2015, time=2015-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1827969, encodeId=8d12182e96953, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Jan 31 11:17:00 CST 2015, time=2015-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14277, encodeId=db83142e7cf, content=他汀仍然有一定保护作用, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=175.9.205.**, createdTime=Tue Jan 13 22:27:00 CST 2015, time=2015-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14269, encodeId=a699142697a, content=有必要再按不同年龄段进行亚组分析, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=lovetcm, createdTime=Tue Jan 13 21:50:00 CST 2015, time=2015-01-13, status=1, ipAttribution=)]
    2015-01-31 howi
  4. [GetPortalCommentsPageByObjectIdResponse(id=2044361, encodeId=4647204436110, content=<a href='/topic/show?id=644725344b1' target=_blank style='color:#2F92EE;'>#他汀类药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25344, encryptionId=644725344b1, topicName=他汀类药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Sun May 31 21:17:00 CST 2015, time=2015-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643354, encodeId=f5b11643354d8, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Thu Jul 23 18:17:00 CST 2015, time=2015-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1827969, encodeId=8d12182e96953, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Jan 31 11:17:00 CST 2015, time=2015-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14277, encodeId=db83142e7cf, content=他汀仍然有一定保护作用, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=175.9.205.**, createdTime=Tue Jan 13 22:27:00 CST 2015, time=2015-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14269, encodeId=a699142697a, content=有必要再按不同年龄段进行亚组分析, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=lovetcm, createdTime=Tue Jan 13 21:50:00 CST 2015, time=2015-01-13, status=1, ipAttribution=)]
    2015-01-13 175.9.205.**

    他汀仍然有一定保护作用

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2044361, encodeId=4647204436110, content=<a href='/topic/show?id=644725344b1' target=_blank style='color:#2F92EE;'>#他汀类药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25344, encryptionId=644725344b1, topicName=他汀类药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Sun May 31 21:17:00 CST 2015, time=2015-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1643354, encodeId=f5b11643354d8, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Thu Jul 23 18:17:00 CST 2015, time=2015-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1827969, encodeId=8d12182e96953, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Jan 31 11:17:00 CST 2015, time=2015-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14277, encodeId=db83142e7cf, content=他汀仍然有一定保护作用, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=175.9.205.**, createdTime=Tue Jan 13 22:27:00 CST 2015, time=2015-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14269, encodeId=a699142697a, content=有必要再按不同年龄段进行亚组分析, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=lovetcm, createdTime=Tue Jan 13 21:50:00 CST 2015, time=2015-01-13, status=1, ipAttribution=)]
    2015-01-13 lovetcm

    有必要再按不同年龄段进行亚组分析

    0

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郭艺芳点评:强效降胆固醇:大剂量他汀还是常规剂量他汀联合依折麦布?(IMPROVE-IT研究)

2014年AHA年会期间揭晓了IMPROVE-IT研究结果。近年来,此研究一直受到广泛期待。之所以如此,是因为这项研究或可回答两个至关重要的问题:(1)降胆固醇是硬道理还是他汀是硬道理?已有充分证据显示,应用他汀降低胆固醇水平可以显著降低心血管病患者及其高危人群不良心血管事件的发生率。但应用其他药物降低胆固醇水平是否产生同样的获益尚不清楚。(2)当LDL-C处于较低水平时继续降低其水平可否进一步获

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