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スタチン薬と脳内出血:共同研究による系統的レビューとメタ解析
Daniel G Hackam1, Mark Woodward, L Kristin Newby
1University of Western Ontario, London, Canada. dhackam@uwo.ca
Circulation
|October 19, 2011
まとめ
スタチンは,ランダム化および観察研究の体系的レビューによると,脳内出血のリスクを増加させない. 潜在的なリスクは小さく,心血管の利点に相殺されます.
科学分野:
- 心血管医学 心血管医学
- 神経学 神経学とは
- 薬理学 薬理学とは
背景:
- 以前の試験では,スタチンが脳内出血のリスクを高めると示唆されていた.
- このシステマティック・レビューは,スタチン薬と脳内出血との関連を扱っています.
研究 の 目的:
- スタチンと脳内出血のリスクとの関連を体系的に検討する.
- ランダム化制御試験と観察研究の両方のデータを分析する.
主な方法:
- 17のデータベースを体系的に検索し,専門家に相談した.
- 23のランダム化試験と19の観察研究 (248,391人の患者,14,784人の出血) のデータをプールした.
- ランダム効果モデルを使用して,概要リスク比率を計算し,研究設計を別々に分析しました.
主要な成果:
- ランダム化試験 (RR 1.10),コホート研究 (RR 0.94),症例対照研究 (RR 0.60) で脳内出血のリスクの増加は認められなかった.
- 症例対照研究 (I2=66%) で異質性が認められたが,コホート研究 (I2=0%) やランダム化試験 (I2=30%) で異質性が認められなかった.
- 感受性分析は,さまざまな患者および試験の特徴において,これらの発見を確認した.
結論:
- スタチンの使用と脳内出血との関連を裏付ける証拠はありません.
- リスクがある場合,それは小さい可能性があり,スタチンの重要な心血管上の利点に相殺されます.
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