心脏和雌激素/孕激素替代研究中的子组相互作用:我们从中吸取了教训
Curt D Furberg1, Eric Vittinghoff, Michael Davidson
1Wake Forest University School of Medicine, Winston-Salem, NC 27157-1063, USA. cfurberg@wfubmc.edu
Circulation
|February 28, 2002
概括
绝经后的激素治疗在冠状动脉心脏病 (CHD) 的特定亚组妇女中没有明显的益处或危害. 需要进一步的研究来探索激素治疗效果的潜在修饰剂.
科学领域:
- 心血管医学 心血管医学
- 内分泌学 在内分泌学.
- 妇女健康 妇女健康
背景情况:
- 心脏和雌激素/孕激素替代研究 (HERS) 在患有冠状动脉心脏病 (CHD) 的女性中没有发现绝经后激素治疗的整体益处.
- 之前对HERS数据的分析没有确定有明显治疗益处或危害的特定子组.
研究的目的:
- 分析针对不同反应于更年期后荷尔蒙治疗的特定女性子组的HERS数据.
- 调查基线特征和激素治疗效果之间的潜在相互作用.
主要方法:
- 根据基线特征对86个预定义的子组进行了广泛的后期分析.
- 对与治疗分配有显著相互作用的变量进行了小组内治疗效应的检查.
- 在1年和试验结束时评估治疗效果.
主要成果:
- 一年后,六个相互作用值是名义上显著的 (P<0.05),在试验完成时有3个显著.
- 数字的使用,心肌梗塞史和脂蛋白水平出现了作为激素治疗效果的潜在修饰剂.
- 没有小组显示激素治疗的明显有益或有害影响.
结论:
- 广泛的特异性后期分析没有确定任何子组,其中绝经后激素治疗显然有益或有害.
- 几种激素治疗效果的潜在修饰剂在未来的临床试验中需要进一步调查.
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