固定剂量组合疗法在不同组的初级心血管疾病预防:一个单个参与者的元分析
Gilles R Dagenais1, Prem Pais2, Peggy Gao3
1Health Research Center, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada gilles.dagenais@criucpq.ulaval.ca.
Heart (British Cardiac Society)
|May 31, 2023
概括
固定剂量组合 (FDC) 药物在中等风险人群中显著降低了心血管风险. 老年人从FDC中获得了更大的好处,特别是与阿司匹林结合时.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 临床试验 临床试验
背景情况:
- 心血管疾病仍然是全球死亡的主要原因.
- 初级预防策略对于减少心血管事件至关重要.
- 固定剂量组合 (FDC) 药物为管理多种风险因素提供了一种简化方法.
研究的目的:
- 评估FDC药物对不同年龄组心血管结果的影响.
- 分析FDC在中等心血管风险人群中初级预防中的有效性.
- 为了确定年龄是否影响FDC治疗的好处.
主要方法:
- 一个个人参与者对三项随机对照试验的元分析.
- 包括18162名中等心血管风险 (17.7%的10年弗雷明汉风险) 的参与者.
- 随机分配到FDC (抗高血压药物+/-他类药物+/-阿司匹林) 或对照组,随时跟踪5年.
主要成果:
- 在总人口中,FDCs将主要结局风险降低了37% (HR 0.63).
- 较年长的年龄组 (60-65岁和≥65岁) 显示出明显更大的益处 (HR分别为0.58和0.57).
- 与阿司匹林配合的FDC显示出增强的风险降低,特别是在老年人中,年轻参与者的头更频繁.
结论:
- 对于中等风险的个人来说,FDC提供了相当大的心血管益处.
- 老年人从FDC中获得了更大的心血管保护.
- 将阿司匹林添加到FDC中可能会进一步增强益处,特别是在老年人群中.
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