低密度脂質コレステロールを低減して心血管疾患を予防する 低密度脂質コレステロールレベルが190mg/dL以上で上昇した男性: WOSCOPS (West of Scotland Coronary Prevention Study)
Antonio J Vallejo-Vaz1, Michele Robertson2, Alberico L Catapano3
1Imperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom (A.J.V.-V., K.K.R.).
Circulation
|September 8, 2017
まとめ
スタチンの治療は,低密度脂質タンパク質コレステロール (LDL- C) を,LDL- C ≥190 mg/ dLの個体における初等予防に効果的に低下させる. この研究では,短期および長期にわたる心臓血管疾患に対する有意な効果が確認され,高リスク患者での使用を裏付けています.
科学分野:
- 心臓病科
- 予防 医療
- 薬理学について
背景:
- LDL-C ≥190 mg/ dLの患者は動脈硬化性心血管疾患のリスクが高まります.
- スタチンの治療は推奨されますが,主予防試験のデータは限られています.
- この分析は,この集団におけるLDL-Cの低下に関する新しいデータを提供します.
研究 の 目的:
- 主要予防におけるLDL-Cの低下による心血管上の効果を評価する.
- 以前の血管疾患のないLDL-C ≥190 mg/dLの個体でのアウトカムを分析する.
主な方法:
- WOSCOPSのランダム化試験とフォローアップのポストホック分析
- ベースライン血管疾患のない5529人の男性を含む.
- プラバスタチンとプラセボによる心血管疾患と死亡率の20年間の評価
主要な成果:
- プラバスタチンは,LDL- C ≥190 mg/ dL群で冠動脈疾患 (CHD) のリスクを27%,主要な不良心血管事件 (MACE) を25%減少させた.
- これらの効果は,LDL-C値に一致した.
- 長期フォローアップでは,プラバスタチンによる心臓病による死亡 (28%),心血管疾患による死亡 (25%),全原因による死亡 (18%) が減少した.
結論:
- LDL-Cを低下させる短期的および長期的利点の有力な証拠を提供します.
- LDL-C ≥190 mg/ dLの個体におけるプライマリ予防のためのスタチン治療をサポートする.
- この高リスク集団における心臓血管疾患のリスクを低減する効果を示しています.
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