スタチン療法,心血管疾患,および心臓およびエストロゲン/プロゲステン置換研究 (HERS) の全死亡率
David M Herrington1, Eric Vittinghoff, Feng Lin
1Department of Internal Medicine/Cardiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. dherring@wfubmc.edu
Circulation
|June 26, 2002
まとめ
心臓病のある閉経後の女性におけるスタチンの使用は,心血管疾患,静脈性血栓塞栓症および全死亡率を著しく低下させた. これらの発見は,冠動脈疾患を有する適格な女性のスタチン療法を支持しています.
科学分野:
- 心血管医学 心血管医学
- 薬理学 薬理学とは
- 女性の健康 女性の健康
背景:
- スタチンの心血管上の結果は,男性では確立されていますが,女性ではそれほどありません.
- スタチン薬とホルモン置換療法 (HRT) が心血管疾患のアウトカムに及ぼす効果は,依然として不確実である.
研究 の 目的:
- スタチンの使用が心血管疾患を患う閉経後の女性における心血管疾患および死亡率に及ぼす影響を調べる.
- スタチンの使用とホルモン置換療法 (HRT) が心血管のアウトカムに及ぼす相互作用を調査する.
主な方法:
- ランダム化臨床試験である心臓とエストロゲン/プロゲスチン置換試験 (HERS) のデータの分析.
- スタチン使用者と非使用者の非ランダム化比較で,心疾患を持つ2763人の閉経後の女性を対象とした研究.
主要な成果:
- スタチンを服用した人は,プライマリアウトカム (非致死性心筋梗塞または冠動脈疾患による死亡) の割合が低かった (RH=0.79,P=0.04).
- スタチンの使用は,全死亡率 (RH=0.67,P=0.003) と静脈性血栓塞栓性イベント (RH=0.45,P=0.02) を有意に低下させた.
- ホルモン置換療法 (HRT) は,スタチンを服用していない患者では初発症のリスクが増加したが,スタチンを服用している患者ではそうではない. 調整した分析では,HRTが初発症への影響を示さなかった.
結論:
- 冠動脈疾患の閉経後の女性のスタチンの使用は,心血管疾患,静脈血栓栓症および全死亡率の減少と関連しています.
- これらの発見は,既存の冠動脈疾患を有する適格な女性のスタチンの使用を強く支持しています.
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