急性冠動脈症候群後の早期死亡率に対する脂質低下療法の効果:観察研究

H D Aronow¹, E J Topol, M T Roe

¹Department of Cardiology, Cleveland Clinic Foundation, OH 44195, USA.

Lancet (London, England)

|April 12, 2001

まとめ

急性冠動脈症候群の後に脂質低下薬を処方すると,短期的な死亡率が著しく低下します. この発見は,心疾患の後に患者のアウトカムを改善するために,早期のスタチン治療の重要性を強調しています.

科学分野:

心臓病学心臓病学
薬理学薬理学とは
クリニカル・メディシン臨床医学

背景:

脂質低下剤は,冠動脈疾患における長期的な死亡率を減らすために確立されています.
これらの薬剤が急性冠動脈症候群 (ACS) 後の短期死亡率に与える影響は不明である.

研究の目的:

急性冠動脈症候群の後の患者における脂質低下療法と短期的な死亡率との関連性を調査する.

主な方法:

GUSTO IIbとPURSUITのランダム化試験のデータを利用した観察研究.
脂質低下剤で退院したACS患者の死亡率と,治療を受けていない患者の死亡率の比較.
処方慣行における選択バイアスを制御するための雇用傾向分析.

主要な成果:

脂質低下療法が30日 (0.5%対1.0%) と6ヶ月 (1.7%対3.5%) の死亡率の低下と関連していた.
傾向スコアを調整した後も,退院時に処方される脂質低下剤は6ヶ月の死亡リスクの低下と関連していた (HR 0.67; P=0.023).

結論:

ACS後の早期処方された脂質低下薬は,短期死亡率の低下と独立して関連しています.
退院時に脂質低下療法を開始すると,ACS患者の即時の結果が改善される可能性があります.

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