在ODYSSEY OUTCOMES中阿利洛库马布对中风的影响
J Wouter Jukema1, Laurien E Zijlstra1, Deepak L Bhatt2
1Department of Cardiology, Leiden University Medical Center, The Netherlands (J.W.J., L.E.Z.).
Circulation
|November 12, 2019
概括
在近期患有急性冠状动脉综合征的患者中,alirocumab显著降低了缺血性中风的风险. 这种PCSK9抑制剂没有增加出血性中风的风险,即使LDL- C水平很低.
科学领域:
- 心血管医学
- 神经学
- 药理学
背景情况:
- 降低动脉质脂蛋白,包括LDL-C,降低缺血性中风的风险.
- 人们对非常低的LDL- C水平和潜在的出血性中风风险存在担忧.
- 在ODYSSEY OUTCOMES试验中,尽管接受了他类药物治疗,但最近患有急性冠状动脉综合征和高LDL- C的患者接受了alirocumab的研究.
研究的目的:
- 评估阿利罗库马布对缺血性和出血性中风风险的影响.
- 根据基线的LDL- C或脑血管疾病史,确定阿里古马布对中风的影响是否有所不同.
- 在接受阿里古马布治疗的患者中评估非常低的LDL-C与出血性中风风险之间的关联.
主要方法:
- 在急性冠状动脉综合征后患者中,随机比较alirocumab与安慰剂.
- 评估非致命或致命的缺血和出血性中风风险.
- 根据基线LDL-C和脑血管疾病史进行分层分析.
主要成果:
- 在不增加出血性中风风险的情况下,alirocumab降低了任何中风的风险 (HR 0. 72) 和缺血性中风 (HR 0. 73).
- 在不同基线LDL- C水平和有或没有脑血管疾病史的患者中,治疗效果一致.
- 在alirocumab组中,没有观察到非常低的LDL- C与出血性中风发生率之间的不良关联.
结论:
- 在患有急性冠状动脉综合征和脂质失调症的患者中,阿利罗库马布降低了中风风险,而不考虑基线LDL- C或脑血管病史.
- 血流性中风的风险与阿里古马布治疗组的LDL- C水平无关.
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