皮塔瓦斯塔丁用于预防艾滋病毒感染中的心血管疾病
Steven K Grinspoon1, Kathleen V Fitch1, Markella V Zanni1
1From the Metabolism Unit (S.K.G., K.V.F., M.V.Z., M.R.D., E.S.F., S.E.L., S.M.), the Cardiovascular Imaging Research Center, Department of Radiology (K.P., B.F., M.T.L.), and the Yvonne L. Munn Center for Nursing Research (S.E.L.), Massachusetts General Hospital and Harvard Medical School, the Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health (T.U., J.L.-C., H.J.R.), and the Thrombolysis in Myocardial Infarction Study Group, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School (S.D.W.) - all in Boston; the Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati (C.J.F.), and the Division of Infectious Diseases, Ohio State University Medical Center, Columbus (C.D.M.); the Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York (J.A.A.); the Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (E.T.O.); the Department of Medicine, Duke Global Health Institute and Duke Clinical Research Institute, Duke University (G.S.B.), and Duke University Research Institute, Duke University School of Medicine (P.S.D.) - both in Durham, NC; the Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (J.S.C.); the Infectious Diseases Service, Hospital Clinic and University of Barcelona, Barcelona, and CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid - both in Spain (E.M.); DLH, Silver Spring (J.C.R.), and the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute (P.D.-N.), and the Division of AIDS, National Institute of Allergy and Infectious Diseases (B.A.-S.), National Institutes of Health, Bethesda - all in Maryland; and Cleerly, Denver (U.H.).
每日服用皮塔瓦斯塔丁可显著降低人类免疫缺陷病毒 (HIV) 感染者主要不良心血管事件的发生. 这项研究强调了皮塔瓦斯塔丁作为艾滋病毒阳性人群中初级心血管疾病预防的关键策略.
科学领域:
- 心血管医学 心血管医学
- 传染性疾病 传染性疾病
- 临床试验 临床试验
背景情况:
- 人类免疫缺陷病毒 (HIV) 感染的个体面临心血管疾病 (CVD) 的风险增加.
- 在这个弱势群体中,急需有效的心血管疾病初级预防策略.
- 抗逆转录病毒疗法 (ART) 是艾滋病毒的标准治疗,但心血管疾病风险仍然令人担忧.
研究的目的:
- 评估皮塔瓦斯塔丁在预防艾滋病毒感染者的重大心血管不良事件 (MACE) 的疗效.
- 评估皮塔瓦斯塔丁在这个特定的患者群体中的安全性和耐受性.
- 为艾滋病毒感染者提供关于初级心血管疾病预防策略的数据.
主要方法:
- 一个3期随机的,安慰剂控制的试验,涉及7769名艾滋病毒感染者接受ART治疗,心血管疾病风险低至中等.
- 参与者每天接受皮塔瓦斯塔丁 (4毫克) 或安慰剂.
- 主要结局是MACE的复合发病率,包括心血管死亡,心肌梗塞,中风和其他心血管事件.
主要成果:
- 在平均随访时间为5.1年后,该试验因有效性而提前停止.
- 与安慰剂相比,皮塔瓦斯塔丁显著降低了MACE的发病率35% (4.81对7.32每1000人年;危险比,0.65;P=0.002).
- 与肌肉相关的症状和新发糖尿病在皮塔瓦斯塔丁小组中发生的频率略高,但通常耐受良好.
结论:
- 每日服用皮塔瓦斯塔丁可显著降低艾滋病毒感染个体发生重大心血管不良事件的风险.
- 皮塔瓦斯塔丁代表了艾滋病毒阳性人口中心血管疾病的宝贵初级预防策略.
- 这些发现支持使用皮塔瓦斯塔丁来减少艾滋病毒感染者心血管疾病负担.
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