通过IcosapentEthyl减少再血管:来自REDUCE-IT再血管分析的见解
Benjamin E Peterson1, Deepak L Bhatt1, Ph Gabriel Steg2
1Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (B.E.P, D.L.B., R.P.G.).
Circulation
|November 5, 2020
概括
在接受他类药物治疗的高风险患者中,Icosapent ethyl显著降低了冠状动脉再血管,包括旁路手术. 这种非他类药物治疗为预防心血管疾病提供了一种新方法.
科学领域:
- 心脏病学
- 药理学
- 临床试验
背景情况:
- 在接受他类药物治疗的患者中,甘油三水平升高与缺血事件的风险增加有关,例如冠状动脉再血管.
- 确定有效的治疗方法来减轻这种风险对于预防心血管疾病至关重要.
研究的目的:
- 评估icosapent乙烯在降低冠状动脉复血管化的效果,在治疗他类药物的患者中增加了甘油三和心血管风险.
- 分析icosapent乙烯对各种类型的复血管化程序的影响.
主要方法:
- 这项REDUCE- IT试验是一项多中心,双盲,安慰剂对照试验,涉及8179名患者.
- 患者除了接受他类药物治疗外,还接受了icosapent ethyl (4 g/ d) 或安慰剂治疗.
- 随访时间的中位数为4. 9年,预先对复血管化事件进行了分析.
主要成果:
- 伊科萨乙烯降低了34%的初次复血管化 (HR,0. 66;P< 0. 0001) 和36%的总复血管化 (率比,0. 64;P< 0. 0001).
- 在选择性,紧急和突发性重血管化 (包括穿皮冠状动脉干预和冠状动脉旁路移植) 中观察到显著的减少.
- 需要治疗4. 9年以防止一次重血管化的人数为24人.
结论:
- 在治疗他类药物的高风险患者中,Icosapent ethyl有效地减少了第一次和随后的冠状动脉再血管化的需要.
- 它是第一个非低密度脂蛋白降低疗法,在一个盲目的随机试验中被证明可以减少冠状动脉旁路移植.
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