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Heart:研究发现,两年他汀一级预防,半数血脂不达标,其心血管风险增加22%

2019-04-21 朱柳媛 中国循环杂志

来自英国的一项全国性前瞻性队列研究显示,大约一半的心血管病一级预防人群在服用他汀类药物2年后,其胆固醇水平仍未达到“健康”状态,且未达标者风险增加。

来自英国的一项全国性前瞻性队列研究显示,大约一半的血管病一级预防人群在服用他汀类药物2年后,其胆固醇水平仍未达到“健康”状态,且未达标者风险增加。

所谓的“健康”状态,是指英国国立健康与临床优化研究所(NICE)指南提出的“应用他汀24个月内低密度脂蛋白胆固醇(LDL-C)水平降低40%”目标。研究者指出,要想达到这一目标,有必要针对高胆固醇血症患者给予个体化医疗。

该研究分析了英国临床实践研究数据链中的16.5万余人。这些人在启用他汀前无血管病,应用他汀进行心血管病一级预防

中位随访6.2年期间,发生了22 798例(13.8%)心血管事件,其中53.3%为LDL-C水平未达标者。

研究者发现,应用他汀24个月内,51.2%的患者LDL-C水平未达到NICE指南目标。校正年龄和基线未治疗时LDL-C水平等因素后,这些患者发生心血管事件的风险比LDL-C水平达标者增加22%。

在这些LDL-C水平未达标的患者中,LDL-C水平每下降1 mmol/L,脑卒中和轻型卒中发生风险仅降低6%;相应地,在LDL-C达标的患者中心血管病风险可降低13%。

研究者指出,这项观察性研究并不能得出因果关系,但反映的是真实世界经验,且纳入了大量患者,随访时间较长,因此应该也适用于别的患者群。

原始出处:
Akyea RK1, Kai J1, Qureshi N1,et al.Sub-optimal cholesterol response to initiation of statins and future risk of cardiovascular disease.Heart. 2019 Apr 15. pii: heartjnl-2018-314253. doi: 10.1136/heartjnl-2018-314253. [Epub ahead of print]

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    2019-04-23 zhaojie88
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    2019-04-23 slcumt

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