心臓とエストロゲン/プロゲステン置換研究におけるサブグループ相互作用:教訓
Curt D Furberg1, Eric Vittinghoff, Michael Davidson
1Wake Forest University School of Medicine, Winston-Salem, NC 27157-1063, USA. cfurberg@wfubmc.edu
Circulation
|February 28, 2002
まとめ
閉経後のホルモン療法は,冠動脈性心疾患 (CHD) を患っている女性の特定のサブグループでは,明確な利益や害を示さなかった. ホルモン療法の効果の潜在的な変形因子を調査するためにさらなる研究が必要である.
科学分野:
- 心血管医学は,心臓血管医学である.
- エンドクリノロジー エンドクリノロジー
- 女性の健康 女性の健康
背景:
- The Heart and Estrogen/Progestin Replacement Study (HERS) は,冠動脈性心疾患 (CHD) の女性における閉経後のホルモン治療の全体的な利点が見つかりませんでした.
- HERSデータに関する以前の分析では,治療の明らかな利益や害を持つ特定のサブグループが特定されなかった.
研究 の 目的:
- 閉経後のホルモン治療に異なった反応を示した女性の特定のサブグループに関するHERSデータを分析する.
- ベースラインの特徴とホルモン療法の効果の間の潜在的な相互作用を調査する.
主な方法:
- ベースラインの特徴に基づいて,事前に定義された86つのサブグループの広範なポストホック分析を実施しました.
- 治療の割り当てと有意に相互作用する変数について,サブグループ内の治療効果を調べた.
- 1年後の治療効果と試験終了後の治療効果を評価した.
主要な成果:
- 6つの相互作用値は,1年後に名目的に有意 (P<0.05) であり,3つは試験終了時に有意であった.
- デジタリスの使用,心筋梗塞の病歴,およびリポプロテイン (a) レベルは,ホルモン療法の効果の潜在的な修正因子として浮上しました.
- ホルモン療法の明らかな有益または有害な効果を示すサブグループはありませんでした.
結論:
- 広範なポストホック分析では,閉経後のホルモン治療が明らかに有益または有害であるサブグループを特定できませんでした.
- ホルモン療法の効果のいくつかの潜在的な変形剤は,将来の臨床試験でさらなる調査を正当化します.
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