血中胆固醇指南对美国人口使用中断时间序列分析对他类药物治疗的潜在影响
Pui Ying Yew1, Matt Loth1,2, Terrence J Adam1,3
1Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA.
BMC cardiovascular disorders
|May 10, 2024
概括
2013年ACC/AHA指南改善了糖尿病组的5年MACE存活率和ASCVD组的最佳他类药物使用. 这些发现表明,这可能对患者的治疗结果和处方行为产生长期的积极影响.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 2013年ACC/AHA指南通过定义四个他类药物的益处组,彻底改变了脂质管理.
- 之前关于指南影响的研究往往忽视了长期影响和通用阿托瓦斯塔丁可用性的影响.
研究的目的:
- 评估2013年ACC/AHA指南对主要不良心血管事件 (MACE) 存活率的长期影响.
- 为了评估他类药物使用的变化,最佳的他类药物使用,以及在指南发布后的他类药物坚持,控制通用阿托瓦斯塔丁的可用性.
主要方法:
- 美国全国索赔和电子健康记录的回顾性分析 (Optum Labs数据库仓库).
- 间断时间序列分析 (Chow的测试) 以确定5年MACE存活率和他类药物相关结果的趋势变化.
- 包括197,021名患者在四个他类药物益处组:ASCVD,高LDL,糖尿病和高ASCVD风险.
主要成果:
- 在糖尿病组观察到5年MACE存活率的显著长期改善 (P=0.002).
- 在ASCVD组 (P<0.001) 观察到最佳他类药物使用的立即和持续的积极变化 (P<0.001).
- 在所有组中,整体他类药物的使用或坚持没有显著的趋势变化.
结论:
- 2013年ACC/AHA指南与糖尿病组中改善的长期MACE存活率和ASCVD组中最佳的他类药物使用有关.
- 这些发现表明,这可能会对高风险人群的初级预防和处方行为产生积极影响.
- 需要进一步的研究来确定指南和观察到的结果之间的确切因果关系.
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