根据中风亚型的二次预防中素的作用:CONVINCE随机试验的二次分析
Louise Maes1,2, Cathal Walsh3, Christian Weimar4
1Department of Neurology, University Hospitals Leuven, Leuven, Belgium.
概括
科尔奇辛在中风患者中显示出减少主要心血管不良事件 (MACE) 的趋势,无论中风亚型如何. 进一步的研究应该集中在脑卒中预防试验中的动脉样硬化.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 在CONVINCE试验中,研究了长期使用胆固醇来预防中风患者的主要心血管不良事件 (MACE).
- 虽然初级终点没有达到,但黄素显示出较少事件的趋势.
- 脑卒中病因对菌素的疗效的影响尚不清楚.
研究的目的:
- 根据中风病因学,评估科尔奇辛在预防轻微中风或暂时性缺血性发作 (TIA) 的患者中MACE的有效性.
- 这种预先规定的二次分析专注于特定的中风亚型.
主要方法:
- 3154名近期患有非心血管血栓性中风或TIA的患者被随机分组.
- 参与者接受了胆固醇 (每天0.5毫克) 加上常规护理或仅接受常规护理.
- 主要终点包括复发性缺血性中风,心肌梗塞,心脏骤停或不稳定性心痛住院治疗. 对大动脉动脉样硬化,小血管疾病和密码性中风进行了亚组分析.
主要成果:
- 该分析包括3100名患者,治疗效果和中风亚型之间没有显著的相互作用 (p=0.64).
- 在大动脉动脉样硬化 (HR 0.77),小血管阻塞 (HR 0.87),密码性中风 (HR 0.89) 亚组中,科尔奇辛呈现出减少MACE的持续趋势.
- 在所有评估的中风亚型中,特定事件发生率有利于胆固醇.
结论:
- 科尔奇辛在预防中风患者中复发的MACE方面表现出有利的趋势,无论中风亚型如何.
- 这些发现与先前的冠状动脉疾病试验一致,这表明在动脉样硬化血管疾病中存在潜在的益处.
- 未来的中风试验应考虑根据动脉样硬化的证据来选择患者,无论具体的中风分类如何.
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