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心血管疾病患者的他类药物和败血症:基于人口的队列分析
Daniel G Hackam1, Muhammad Mamdani, Ping Li
1Division of Clinical Pharmacology and Toxicology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Canada.
Lancet (London, England)
|February 7, 2006
概括
类药物显著降低了动脉样硬化患者的败血症风险. 这一发现表明,他类药物可能提供抗败血症的保护性益处,这需要通过随机试验进一步调查.
科学领域:
- 心血管医学 心血管医学
- 传染病流行病学 传染病流行病学
背景情况:
- 动脉样硬化和败血症共享炎症和血栓性途径.
- 对于他类药物治疗对动脉样硬化患者败血症风险的影响尚不清楚.
研究的目的:
- 调查他类药物使用与动脉样硬化患者发生败血症的风险之间的关联.
主要方法:
- 加拿大安大略省连接的行政数据库的基于人口的队列分析 (1997-2002).
- 包括1414487名65岁以上因急性冠状动脉综合征,缺血性中风或再血管化而住院的患者,在出院后存活了≥3个月.
- 倾向性得分匹配创造了一个由69,168名患者组成的平衡队列 (34,584名他类药物使用者,34,584名非使用者).
主要成果:
- 与非使用者 (88.0事件/10,000人年;HR 0.81) 相比,他类药物使用者的败血症发病率较低 (71.2事件/10,000人年).
- 经过调整后的分析证实了保护性关联 (HR 0.81),在高危子组 (糖尿病,功能衰竭,先前感染) 中一致.
- 类药物减少了严重的 (HR 0.83) 和致命的败血症 (HR 0.75);非类药物降脂剂没有显示好处 (HR 0.95).
结论:
- 动脉样硬化患者使用他类药物与随后败血症风险降低有关.
- 这些发现支持需要进行随机对照试验,以确认他类药物在败血症预防中的有效性.
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