伊科萨乙烯降低了心血管--代谢综合征中的心血管疾病风险:减少-IT CKM
Michael Miller1, Deepak L Bhatt2, Eliot A Brinton3
1Corporal Michael J Crescenz VAMC and Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
American journal of preventive cardiology
|January 30, 2026
概括
心血管--代谢综合征在没有糖尿病的患者中增加了心血管疾病的风险. 伊可萨乙烯显著降低了患有功能不全的患者的这种风险.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 心血管--代谢 (CKM) 综合征将慢性病与代谢综合征 (MetS) 整合在一起.
- 在REDUCE-IT试验中,研究了高风险患者的icosapent乙烯 (IPE).
- CKM对心血管疾病 (CVD) 风险的影响和IPE在没有糖尿病的二次预防中的有效性仍然不清楚.
研究的目的:
- 在没有糖尿病的二次预防患者中评估与CKM相关的渐进性心血管疾病风险.
- 评估IPE对这种特定患者亚组中心血管疾病风险的影响.
主要方法:
- 在REDUCE-IT试验中对患有MetS但在基线没有糖尿病的患者小组的分析 (n=2860).
- 根据估计的淋巴细胞过率 (eGFR) 分类患者:<60,60-<90,≥90毫升/分钟/1.73米2.
- 在安慰剂组中对EGFR组之间的初级和二级终点事件率的比较,并评估每个子组内IPE的影响.
主要成果:
- 与EGFR≥90mL/min/1.73m2 (HR1.44) 和EGFR<60mL/min/1.73m2 (HR1.87) 与EGFR≥90mL/min/1.73m2 (HR1.87) 患者相比,CKM与安慰剂患者中增加的初级复合终点风险有关.
- 在CKM患者 (eGFR <60mL/min/1.73m2) 中,IPE显著降低了与安慰剂相比的主要复合终点 (HR 0.55) 和关键次要复合终点 (HR 0.52).
- IPE显示绝对风险降低11.2%,治疗所需数为9.
结论:
- 在没有糖尿病的二次预防患者中,CKM综合征会增加心血管疾病的风险,特别是患有功能不全的患者.
- IPE治疗显著降低了METS患者患有功能衰竭和已确定的心血管疾病的心血管疾病风险.
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