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Diabetes Care :高胆固醇血症合并糖尿病视网膜病变高风险患者,强化降脂怎么样?

2018-06-28 吴星 环球医学

2018年6月,发表在《Diabetes Care》的一项随机研究报告,考察了高胆固醇血症合并糖尿病视网膜病变的高风险日本患者中,强化靶向他汀治疗的心血管(CV)事件发病率。

2018年6月,发表在《Diabetes Care》的一项随机研究报告,考察了高胆固醇血症合并糖尿病视网膜病变的高风险日本患者中,强化靶向他汀治疗的心血管(CV)事件发病率。

目的:糖尿病与CV事件的高风险相关,尤其是血脂异常和糖尿病并发症患者。研究者考察了强化或标准降脂治疗(靶向治疗方法)的高胆固醇血症合并糖尿病视网膜病变且无冠状动脉疾病史的患者中,CV事件的发病率。

研究设计和方法:在这项多中心、前瞻性、随机、开放性、终点设盲研究中,符合入组标准的患者按照1:1的比例被随机分配到靶向LDL胆固醇(LDL-C)<70mg/dL的强化他汀治疗(2518人)或靶向LDL-C 100~120mg/dL的标准他汀治疗(2524人)组中。

结果:平均随访37±13个月。强化组和标准组36个月时的LDL-C分别为76.5±21.6mg/dL和104.1±22.1mg/dL(P<0.001)。强化组和标准组分别有129和153人发生首要终点事件(风险比[HR],0.84[95% CI,0.67~1.07];P=0.15)。两组LDL-C差异和事件降低率之间的相关性与在糖尿病患者中进行的初级预防研究中的一致。探索性结果表明,强化组大脑事件显著更少(HR,0.52[95% CI,0.31~0.88];P=0.01)。两组之间安全性无显著差异。

结论:研究者未发现强化治疗的CV事件或CV相关死亡的显著降低,可能由于LDL-C的组间差异比预期的低(治疗36个月时为27.7mg/dL)。靶向治疗策略中,实现LDL-C<70mg/dL在高风险患者中的潜在获益值得进一步研究。

原始出处:

Itoh H, Komuro I, Takeuchi M, et.al. Intensive Treat-to-Target Statin Therapy in High-Risk Japanese Patients With Hypercholesterolemia and Diabetic Retinopathy: Report of a Randomized Study. Diabetes Care. 2018 Jun;41(6):1275-1284. doi: 10.2337/dc17-2224. Epub 2018 Apr 6.

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    2018-06-30 zutt
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    2018-06-28 1ddf0692m34(暂无匿称)

    学习了.长知识

    0

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