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随机试验评估二次预防疗法- 斯坦丁和乙胺酸 (RESPECT- EPA) 的有效性

Katsumi Miyauchi¹, Hiroshi Iwata¹, Yuji Nishizaki¹

¹Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan (K.M., H.I., Y.N., H.D.).

|June 14, 2024

概括

在冠状动脉疾病和低EPA/ AA比率的患者中,Icosapent ethyl显示出降低心血管事件的趋势. 然而,主要终点没有达到统计意义,尽管二次冠状动脉事件有所减少.

科学领域:

心脏病学
药理学
生物化学

背景情况:

低血乙酸 (EPA) 水平与心血管事件风险增加有关.
这项研究重点关注冠状动脉疾病 (CAD) 和低EPA/ 酸 (AA) 的患者,这些患者往往接受治疗不足.

研究的目的:

评估icosapent乙烯在降低心血管事件的有效性,在患有CAD,低EPA/ AA比率,和在类他类药物治疗.
评估icosapent乙烯对心血管事件的初级和二级复合终点的影响.

主要方法:

这是一项前性,多中心的,随机的,开放的,盲目的终点研究,涉及日本3884名患者.
患有稳定的CAD和EPA/ AA比率< 0. 4的患者被随机分为每天接受icosapent乙烯 (EPA) 或对照剂.
主要终点:结合心血管死亡,心肌梗塞,缺血性中风,不稳定性心痛和再血管化. 二次终点集中在冠状动脉事件上.

主要成果:

主要综合终点发生在EPA组的9. 1%与对照组的12. 6% (HR 0. 79,P=0. 055) 中,这一趋势不显著.
在冠状动脉事件的二次复合终点 (6. 6% 与 9. 7%; HR 0. 73, P=0. 042) 中观察到显著的减少.
在EPA组中,新发性心房显著增加 (3.1%对1. 6%,P=0. 017),其他不良事件没有差异.

结论:

Icosapent ethyl显示心血管事件的风险较低,但在该人群中没有达到统计学意义.
这项研究强调了对二次冠状动脉事件的潜在益处,需要进一步调查.
对于使用icosapent ethyl来说,心房动的风险增加是一个考虑因素.

关键词:

冠状动脉疾病乙酸结果评估, 医疗保健

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