白血球数は,プラバスタチンによる冠動脈性心疾患の死亡率の低下を予測しています
Ralph A H Stewart1, Harvey D White, Adrienne C Kirby
1Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. rstewart@adhb.govt.nz
Circulation
|April 6, 2005
まとめ
白血球数 (WBC) の増加は炎症を示し,心血管疾患のリスクが高いことを予測します. スタチンの治療は,プラバスタチンのように,炎症患者のこのリスクを大幅に軽減し,炎症のある個人にスタチンのより大きな利益を示唆します.
科学分野:
- 心臓病学 心臓病学
- 炎症の研究 炎症の研究
- 薬理学 薬理学とは
背景:
- 炎症マーカーの上昇は,長期的な心血管疾患のリスクの増加と関連しています.
- スタチンは,抗炎症的性質を有し,炎症患者の心血管リスクの軽減を潜在的に強化する可能性があります.
研究 の 目的:
- 炎症のマーカーである白血球数 (WBC) と冠動脈性心疾患 (CHD) の死亡率との関連を調査する.
- プラバスタチン治療が,既発性心疾患の患者におけるWBCとCHDの死亡率の関係を変化させるかどうかを判断する.
主な方法:
- 発血性疾患におけるプラバスタチンによる長期介入 (LIPID) 試験のデータ分析,9014人の患者を対象とした試験.
- 平均6.0年の追跡期間におけるCHD死亡率との関係におけるベースラインWBCの評価.
- プラバスタチン (40 mg/日) とプラセボを比較し,WBCを治療効果の予測指標として評価.
主要な成果:
- ベースラインのWBCの増加は,プラセボ群では高慢性疾患の死亡率と関連していたが,プラバスタチン群ではそうではなかった (相互作用のP=0.004).
- プラバスタチン治療は,ベースラインのWBCのクォーティルの増加を通じて,1000人の患者に0〜38人のCHD死亡を予防しました.
- ベースラインのWBCは,脂質レベルや全身心リスクスコアよりも,スタチン治療の利点のより強力な予測指標でした.
結論:
- この発見は,スタチン療法が,炎症の証拠のある個体において,より大きな心血管リスク減少をもたらすという仮説を裏付けている.
- WBCは,スタチンの治療から最も恩恵を受ける可能性が高い患者を特定するための貴重なマーカーとして機能します.
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