心血管疾患の初次予防のためのスタチン療法
Fiona C Taylor1, Mark Huffman, Shah Ebrahim
1Department of Noncommunicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
JAMA
|November 27, 2013
まとめ
スタチンは,プライマリー予防において,死亡と主要な血管疾患のリスクを大幅に低下させる. このコレステロールを低下させる治療は,がんリスクを増加させず,心血管の安全な保護戦略を提供します.
科学分野:
- 心血管医学 心血管医学
- 薬理学 薬理学とは
- 予防的な心臓病学
背景:
- 心血管疾患 (CVD) のプライマリ予防は,罹病率と死亡率を低減するために極めて重要です.
- スタチンは二次予防に広く使用されていますが,主予防におけるスタチンの役割は継続的な評価を必要とします.
- 主要なCVD予防のための有効で安全な介入の特定は,公衆衛生上の優先事項であり続けています.
研究 の 目的:
- 主要予防のために心血管疾患の減少におけるスタチン治療の有効性を評価する.
- スタチンの安全性プロフィールを評価し,特にがんなどの重篤な有害事象について評価する.
主な方法:
- スタチンとプラセボを比較したランダム化比較試験の系統的レビューとメタ解析.
- 心血管疾患,あらゆる原因による死亡率,がんを含む有害事象を報告した研究を含む.
- スタチンの総合的な効果を決定するための統計的分析.
主要な成果:
- 主要予防におけるスタチンの使用は,あらゆる原因による死亡率の有意な減少と関連していました.
- 心筋梗塞や脳卒中を含む主要な血管疾患は,スタチン療法によって大幅に減少しました.
- スタチン群では,プラセボ群と比較して,再血管化処置の割合も低かった.
- スタチンを服用している患者では,がんのリスクの増加は観察されなかった.
結論:
- スタチンの治療は,心血管疾患および死亡率を減らすための効果的な第一予防戦略です.
- 主要予防におけるスタチンの効果は潜在的なリスクを上回り,がん発生率増加の証拠はない.
- これらの発見は,プライマリ心血管疾患のリスクを減らすために,選択された集団におけるスタチンの使用を支持する.
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