在透析患者中,终身他类药物可以延长寿命吗?
Thomas Ebert1,2, Peter Bárány1,3
1Karolinska Institutet, Division of Renal Medicine, Department of Clinical Science, Intervention and Technology.
Clinical kidney journal
|October 2, 2023
概括
通过随着时间的推移稳定风险,他类药物可能为透析患者提供心血管益处,与风险增加的安慰剂组不同. 这表明在透析的慢性病 (CKD) 患者中对他类药物的使用进行潜在的重新评估.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 临床药理学 临床药理学
背景情况:
- 失脂症是慢性病 (CKD) 中心血管风险的重要因素.
- 对于50岁以上的慢性病患者,不接受透析,建议服用他类药物,以减少心血管事件.
- 目前的指导方针不建议在维持透析的患者中启动他类药物.
研究的目的:
- 分析透析患者心血管事件的时间趋势 糖尿病患者接受阿托瓦斯塔丁治疗与安慰剂对比.
- 讨论这些发现在当前临床实践和用于透析的CKD患者的指导方针的背景下所带来的影响.
主要方法:
- 4D研究的后期分析,涉及有糖尿病的透析患者.
- 随着时间的推移,阿托瓦斯塔丁治疗组和安慰剂组之间的心血管事件率的比较.
主要成果:
- 虽然心血管事件的总数相似,但随着时间的推移,风险概况显著不同.
- 心血管事件的风险在安慰剂组逐渐增加.
- 心血管事件风险在1.5年后稳定,在阿托瓦斯塔丁组保持不变.
结论:
- 阿托瓦斯塔丁对透析患者心血管事件的时间依赖作用需要进一步考虑.
- 这一分析表明,与目前的建议相反,他类药物在稳定该人群中的心血管风险方面具有潜在的益处.
- 可能需要进一步的研究来澄清他类药物在维持透析的CKD患者心血管风险管理中的作用.
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