在患有急性冠状动脉综合征的患者中,早期开始使用他类药物和结果
L Kristin Newby1, Arni Kristinsson, Manjushri V Bhapkar
1Duke Clinical Research Institute, Duke University Medical Center, PO Box 17969, Durham, NC 27715, USA. newby001@mc.duke.edu
JAMA
|June 19, 2002
概括
在急性冠状动脉综合征 (ACS) 后早期开始使用他类药物并没有改善这项研究中的90天或1年的结果. 然而,胆固醇水平可能会影响ACS后早期他类药物治疗的有效性.
科学领域:
- 心脏病学 心脏病学
- 临床试验 临床试验
- 药理学 药理学 是一个学科.
背景情况:
- 确定了他类药物的二次预防益处.
- 在急性冠状动脉综合征 (ACS) 后早期开始服用他类药物的影响尚不清楚.
研究的目的:
- 评估ACS后早期 (在7天内) 开始服用他类药物和90天和1年后患者的结果之间的关联.
主要方法:
- 使用SYMPHONY和第二SYMPHONY随机临床试验数据进行观察性队列分析.
- 包括12365名ACS患者,比较早期开始使用他类药物 (n=3952) 和不使用他类药物治疗 (n=8413).
- 评估了90天和1年的死亡,心肌梗塞 (MI) 和重复性严重缺血的发生率.
主要成果:
- 未经调整的分析表明,早期使用他类药物与较低的死亡率有关.
- 调整后的分析显示,早期使用他类药物和不使用他类药物组之间在90天或1年后的结果 (死亡,死亡/心脏病发作,死亡/心脏病发作/缺血) 中没有显著差异.
- 亚组分析表明,基于与治疗指南相对的胆固醇水平,结果的潜在变化.
结论:
- 在ACS后早期开始使用他类药物与这一队列中改善的临床结果无关.
- 需要进一步进行足够的随机临床试验,以确认早期他类药物治疗对患者结局的影响.
- 胆固醇水平可能会在ACS后早期他类药物治疗的疗效中发挥作用.
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