白血细胞计数预测,减少冠状动脉心脏病死亡率与pravastatin
Ralph A H Stewart1, Harvey D White, Adrienne C Kirby
1Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. rstewart@adhb.govt.nz
Circulation
|April 6, 2005
概括
升高的白细胞计数 (WBC) 表示炎症,并预测更高的心血管风险. 像普拉瓦斯塔丁一样,他类药物治疗在炎症患者中显著降低了这种风险,这表明他类药物对炎症患者的益处更大.
科学领域:
- 心脏病学 心脏病学
- 炎症研究 炎症研究
- 药理学 药理学 是一个学科.
背景情况:
- 炎症标志物升高与长期心血管事件风险增加有关.
- 类药物可能具有抗炎性质,可能增强炎症患者的心血管风险降低.
研究的目的:
- 研究炎症标志物白细胞计数 (WBC) 与冠心病 (CHD) 死亡率之间的关联.
- 确定普拉瓦斯塔丁治疗是否改变了已确定的缺血性心脏病患者中WBC和CHD死亡率之间的关系.
主要方法:
- 从长期干预与普拉瓦斯塔丁在缺血性疾病 (LIPID) 研究的数据分析,一个涉及9014名患者的试验.
- 基线WBC与慢性心脏病死亡率的评估,平均随访时间为6.0年.
- 普拉瓦斯塔丁 (40 mg/d) 与安慰剂的比较,评估WBC作为治疗效益的预测指标.
主要成果:
- 原始水平的WBC增加与安慰剂组的CHD死亡率较高有关,但在普拉瓦斯塔丁组没有 (P的相互作用=0.004).
- 普拉瓦斯塔丁治疗预防了每1000名患者中0至38例心血管疾病死亡,超过了基线WBC的四分位数.
- 基线WBC比脂质水平或全球心脏风险得分更强烈地预测了他类药物治疗的益处.
结论:
- 这些发现支持这样的假设,即他类药物治疗在有炎症证据的个体中提供了更大的心血管风险降低.
- 白血细胞作为一种有价值的标记,用于识别可能从他类药物治疗中受益最多的患者.
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