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在高风险患者中,通过中度强度的他类药物达到LDL-C<70 mg/dL后,升级脂质疗法

Geunhee Park¹, Eui-Young Choi², Sang-Hak Lee³

¹Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Korean circulation journal

|December 29, 2024

概括

升级性降脂疗法 (LLT) 并没有减少高风险患者已经达到LDL-C目标的重大心血管事件或死亡. 然而,强化治疗确实降低了重血管化手术的发生率.

科学领域:

心脏病学心脏病学
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:

目前的指导方针建议针对高危人群的低密度脂蛋白胆固醇 (LDL-C) 目标水平和强化降脂疗法 (LLT).
在通过中等强度的他类药物实现LDL-C目标后,加强LLT的好处仍然不清楚.

研究的目的:

为了评估升级LLT对心血管结局的影响,在患有动脉样硬化心血管疾病 (ASCVD) 的患者中,这些患者已经在中度强度的他类药物中达到LDL-C目标 (<70 mg/dL).

主要方法:

两所大学医院的1,315名ASCVD患者 (2006-2021) 的回顾性倾向得分匹配分析.
患者被分为LLT升级 (n=339) 和非升级 (n=976) 组.
主要结局包括主要的心血管和脑血管不良事件 (MACCE1) 和全因死亡.

主要成果:

在中位数5.7年的随访后,MACCE1率 (心血管死亡,心肌梗塞,缺血性中风) 或所有原因死亡在组之间没有显著差异.
在LLT升级组 (HR,0.70;p=0.017) 中观察到MACCE2率 (包括再血管化) 的显著降低.

结论:

在ASCVD患者中,超过中等强度他类药物的LLT升级,这些患者的LDL-C<70 mg/dL并没有显著减少硬心血管事件或死亡率.
强化LLT在该患者队列中显示出降低冠状动脉或外周再血管化需要的好处.

关键词:

冠状动脉疾病是一种冠状动脉疾病.脱脂血症是什么意思脱脂血症是什么意思基甲基谷氨基-CoA减少酶抑制剂结果评估,医疗保健

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