诺基诺的使用和住院治疗与大动脉动脉瘤或大动脉解剖之间的关联
Jeremy P Brown1, Kevin Wing1, Clémence Leyrat1,2
1Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
JAMA cardiology
|August 16, 2023
概括
在考虑混杂因素后,诺基诺抗生素与大动脉动脉瘤或剖析的风险增加无关. 这项研究提供了关于诺基诺在这些心血管疾病中使用安全性的保证.
科学领域:
- 心血管疾病流行病学
- 药物监督 药物监督 药物监督
- 抗生素安全性 抗生素安全性
背景情况:
- 以前的观察性研究表明,诺基诺使用与大动脉动脉瘤或剖析之间存在联系.
- 这种关联的根本原因仍然不清楚,需要进一步调查.
研究的目的:
- 严格评估诺基诺使用与大动脉动脉瘤或剖析之间的关联.
- 通过使用多种研究设计和数据库来提高研究结果的稳定性.
主要方法:
- 使用英国初级保健记录 (临床实践研究数据链接Aurum和GOLD) 进行了单独的队列和病例交叉研究,与住院数据相关联.
- 分析了从1997年4月至2019年12月期间处方系统性诺基诺或脑素的成年人的数据.
- 用于队列分析的治疗加权考克斯回归和病例交叉分析的条件后勤回归的稳定反向概率,通过元分析汇集估计.
主要成果:
- 原始队列分析显示,诺基诺使用与因大动脉动脉瘤/解剖而增加住院治疗之间的关联 (合并HR,1.28) 但在调整混因素后 (合并调整HR,1.03) 这一关联消失了.
- 病例交叉分析发现,与头素,trimethoprim或co-amoxiclav相比,诺基诺使用和因大动脉动脉瘤/剖开而入院之间没有显著的关联.
- 跨数据库的聚合估计表明,在考虑了潜在的混因素后,在任何研究设计中都没有显著的关联.
结论:
- 这项研究提供了证据表明,当混杂性得到充分解决时,诺基诺的使用与大动脉动脉瘤或剖析的风险增加无关.
- 这些结果为诺基诺的心血管安全提供了保证,特别是在大动脉事件方面.
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