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ADA 2014：CVD风险＜10% 他汀预防治疗成本-效益欠佳

2014-06-18 高晓方 译 医学论坛网

ADA他汀心血管
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美国糖尿病学会(ADA)2014年会的一项报告表明，依据美国心脏病学会/美国心脏学会(ACC/AHA)新指南的推荐，应用他汀类预防心血管疾病(CVD)在增加费用的基础上获益却有限，并且在低风险个体中尤为如此。 此项研究以ACC/AHA指南推荐的两组患者为受试者，并通过全美代表性样本构建了仿真模型。评估动脉粥样硬化CVD和糖尿病的终身风险，以及遵循降脂治疗推荐后每质量调整生命年(QALY)的费用。

美国糖尿病学会(ADA)2014年会的一项报告表明，依据美国心脏病学会/美国心脏学会(ACC/AHA)新指南的推荐，应用他汀类预防心血管疾病(CVD)在增加费用的基础上获益却有限，并且在低风险个体中尤为如此。

此项研究以ACC/AHA指南推荐的两组患者为受试者，并通过全美代表性样本构建了仿真模型。评估动脉粥样硬化CVD和糖尿病的终身风险，以及遵循降脂治疗推荐后每质量调整生命年(QALY)的费用。

结果显示，以5000美元/QALY作为基准，强化他汀类治疗在CVD风险>10%的糖尿病患者中具有成本-效益，但当CVD风险为7.5%～10%时中等度他汀类治疗不具有成本-效益。在非糖尿病成人中，CVD风险>10%时中等度他汀类治疗具有成本-效益，在其他情况下则不具有，尤其是糖尿病前期患者。

会议主持人芝加哥大学Huang博士表示，无CVD的40～75岁糖尿病患者应用他汀类最不具备成本-效益。该组患者的心血管事件风险较低，因此他汀类获益亦较少。当前指南推荐通常采用低密度脂蛋白胆固醇(LDL-C)阈值作为治疗决策依据，但利用基线心血管风险决定什么时候启动他汀治疗可能更为合理。

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    2015-04-11 x35042875

    国真实妊娠糖尿病患病率应该在这两种方案得到的患病率之间

    0

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    2015-04-11 x35042875

    国真实妊娠糖尿病患病率应该在这两种方案得到的患病率之间

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    2015-04-11 x35042875

    国真实妊娠糖尿病患病率应该在这两种方案得到的患病率之间

    0

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    2015-04-11 heli0118

    #治疗成本#

    0

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    2014-10-10 qingrejiedu

    #CVD风险#

    0

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    2014-06-20 医者仁心

    #ADA#

    0

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