已确诊的动脉样性心血管疾病患者的长期使用
Michelle L O'Donoghue1, Robert P Giugliano1, Stephen D Wiviott1
1TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.L.O., R.P.G., S.D.W., J.F.K., K.I., S.A.M., M.S.S.).
Circulation
|August 29, 2022
概括
在高风险患者中,长期使用evolcumab显著降低了心血管事件和死亡. 与安慰剂相比,这种PCSK9抑制剂在8年内表现出持续的安全性和有效性,没有增加不良事件.
科学领域:
- 心血管医学
- 药理学
- 临床试验
背景情况:
- 在FOURIER试验中,evolocumab降低了LDL- C和心血管事件.
- 关于evolcumab安全性和有效性的长期数据是有限的.
研究的目的:
- 评估埃沃洛库马布在患有动脉样硬化心血管疾病的患者的长期安全性和疗效.
- 在长时间内评估心血管结果和不良事件.
主要方法:
- 来自FOURIER试验的患者被纳入了开放式扩展研究 (FOURIER- OLE).
- 从美国和欧洲的扩展研究中汇总了数据,主要分析侧重于不良事件发生率.
- 血脂值和主要心血管不良事件在平均5. 0年的随访期间被前性收集.
主要成果:
- 治疗Evolocumab导致LDL- C的中位数为30 mg/ dL,其中63. 2%的LDL- C达到< 40 mg/ dL.
- 长期不良事件的发生率 (严重的副作用,肌肉事件,新的糖尿病,中风,神经认知事件) 不超过安慰剂,并且没有随着时间的推移而增加.
- 与安慰剂相比,接受evolcumab治疗的患者心血管重大不良事件的风险降低了15%,心血管死亡的风险降低了23%.
结论:
- 长期使用埃沃洛库马布降低LDL-C是安全的,并且可以耐受超过8年.
- 与延迟开始治疗相比,Evolocumab显示持续降低心血管风险.
- 这项研究支持evolocumab在高风险心血管患者的长期益处.
相关概念视频
01:26Atherosclerosis III: Management
26
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
26
01:23Atherosclerosis IV: Nursing Management
43
Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
43
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
33
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
33
01:26Coronary Artery Disease IV: Preventive Measures
31
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
31
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
840
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
840
01:21Rheumatic Heart Disease III: Medical Management
29
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
29