PCSK9 阻害およびスタチン療法による残留炎症リスク
Aruna D Pradhan1,2, Aaron W Aday2,3, Lynda M Rose2
1Department of Medicine, Division of Cardiovascular Medicine, VA Boston Healthcare System, West Roxbury Campus, MA (A.D.P.). apradhan@bwh.harvard.edu.
Circulation
|May 3, 2018
まとめ
スタチンとPCSK9阻害剤による治療は,LDLコレステロールを著しく低下させるが,hsCRP値によって示される残留炎症リスクは持続する. 治療中のhsCRP濃度の上昇は,両方の治療を受けた患者の心血管疾患発生率の増加と関連していました.
科学分野:
- 心臓病科
- 薬理学について
- 炎症に関する研究
背景:
- PCSK9抑制と併用されたスタチンの治療は,LDLコレステロールと心血管疾患を効果的に減少させる.
- 治療中の高感度C反応性タンパク質 (hsCRP) で測定された,残留炎症リスクの役割はよく定義されていません.
研究 の 目的:
- スタチン療法とPCSK9阻害剤のボコシズマブを併用した患者の残留炎症リスクを評価する.
- この患者集団における治療中のhsCRPレベルと心血管疾患発生率との関連性を評価する.
主な方法:
- SPIRE-1およびSPIRE-2試験の9738人の患者のポストホック分析が行われました.
- 治療中のhsCRP (hsCRPOT) とLDL- C (LDL- COT) を測定した.
- 心血管疾患 (心筋梗塞,脳卒中,不安定な胸痛,心血管疾患による死亡) を追跡した.
主要な成果:
- ボコシズマブは14週間でLDL- Cを - 60. 5% 減少させ,hsCRPは最小限の変化を示した.
- hsCRP< sub>OTレベル (> 3 mg/ L) が高かった患者は,hsCRP< sub>OT< 1 mg/ Lの患者と比較して,心血管疾患のリスクが著しく高かった (HR1. 62).
- hsCRP< sub>OTレベルとボコシズマブで達成された相対的なリスク低下との間に有意な相互作用は観察されなかった.
結論:
- スタチンとPCSK9阻害で治療された患者では,治療中のhsCRPの増加によって示される残留炎症リスクが持続する.
- 高度なhsCRPOTレベルは,強烈なLDL- C低下であっても,心血管疾患のリスクが高くなります.
- これらの発見は,併用療法を受けている患者のLDL- Cレベルとは無関係に,炎症経路が心血管リスクに寄与することを示唆しています.
関連する概念動画
01:07Residual Plots
6.5K
A residual plot is a statistical representation of data used to analyze correlation and regression results. It helps verify the requirements for drawing specific conclusions about correlation and regression. To obtain the residual plot, first, the residual for each data value is calculated, which is simply the vertical distance between the observed and the predicted value obtained from the regression equation.
When the residual values are plotted against the variable x, it is called a residual...
When the residual values are plotted against the variable x, it is called a residual...
6.5K
01:26Residual Stresses
658
Residual stresses reside in a structure even after removing the original stress inducer. This phenomenon often arises from varied plastic deformations across different parts of a structure. Consider a rod stretched beyond its yield point. It will not regain its original length due to permanent deformation. Even after load removal, the rod does not entirely lose stress because of uneven plastic deformations, resulting in residual stresses. The computation of these stresses in structures is...
658
00:46Feedback Inhibition
57.3K
Biochemical reactions are occurring constantly in cells, converting starting substances to different products, usually with the help of enzymes that speed the reactions. Without enzymes, it would take far too long for most reactions to occur to be useful to the cell!
57.3K
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
840
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
840
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
1.5K
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
1.5K
01:12Relative Risk
2.2K
Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
2.2K