REDUCE-IT リバスカライゼーション分析からの洞察
Benjamin E Peterson1, Deepak L Bhatt1, Ph Gabriel Steg2
1Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (B.E.P, D.L.B., R.P.G.).
Circulation
|November 5, 2020
まとめ
イコサペントエチルは,スタチン療法を受けた高リスク患者で,バイパス手術を含む冠動脈再血管化を有意に減少させた. この非スタチンの治療は 心血管疾患を予防する新しいアプローチを提供します
科学分野:
- 心臓病科
- 薬理学について
- 臨床試験
背景:
- スタチン療法を受けている患者のトリグリセリド値上昇は,冠動脈再血管化などの不全のリスクが高い.
- このリスクを軽減する効果的な治療法を特定することは 心血管疾患の予防に不可欠です
研究 の 目的:
- イコサペント・エチルの動脈再循環を減少させる効果を評価するため,スタチンを投与したトリグリセリド値が上昇し,心血管疾患のリスクが増加した患者.
- イコサペントエチルの様々なタイプの再血管化手順への影響を分析する.
主な方法:
- REDUCE- IT試験は8179人の患者が参加した多センター,ダブルブラインド,プラセボ対照試験でした.
- 患者はスタチン療法に加えて,イコサペントエチル (4g/ d) またはプラセボを投与された.
- フォローアップ期間は,リバスカライゼーションの事象の事前分析により,平均4. 9年であった.
主要な成果:
- イコサペントエチルは最初の再血管化を34% (HR,0. 66; P< 0. 0001) 減少させ,総再血管化を36% (率比,0. 64; P< 0. 0001) 減少させた.
- 経皮冠動脈介入および冠動脈バイパス移植を含む選択的,緊急および緊急の再血管化は,著しく減少した.
- 1回のリバスカライゼーションを防ぐために必要な治療期間は4. 9年でした.
結論:
- イコサペント・エチルは,スタチン療法を受けた高リスク患者において,最初のおよびその後の冠動脈再血管化の必要性を効果的に軽減します.
- 低密度の脂質タンパク質を低下させない治療法として初めて, 盲検ランダム化試験で冠動脈バイパス移植を減少させることが実証されました.
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