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NEJM:Anacetrapib治疗动脉粥样硬化并不会增加冠脉疾病的发生风险

2017-09-29 MedSci MedSci原创

尽管他汀类药物治疗可有效降低低密度脂蛋白(LDL)胆固醇的水平,但是动脉粥样硬化血管疾病患者仍然是心血管事件的高危患者。Anacetrapib可抑制胆固醇酯转运蛋白(CETP)降低LDL胆固醇水平,并增加高密度脂蛋白(HDL)胆固醇水平。然而,其他CETP抑制剂试验研究显示出对心血管结局的中性或不良影响。研究人员进行了一项随机双盲安慰剂对照试验,纳入了30449名接受强化anacetrapib治疗

尽管他汀类药物治疗可有效降低低密度脂蛋白(LDL)胆固醇的水平,但是动脉粥样硬化血管疾病患者仍然是心血管事件的高危患者。Anacetrapib(安塞曲匹)可抑制胆固醇酯转运蛋白(CETP)降低LDL胆固醇水平,并增加高密度脂蛋白(HDL)胆固醇水平。然而,其他CETP抑制剂试验研究显示出对心血管结局的中性或不良影响。

研究人员进行了一项随机双盲安慰剂对照试验,纳入了30449名接受强化anacetrapib治疗的动脉粥样硬化性血管疾病患者,平均LDL胆固醇水平为61mg / dl(1.58mmol / l),平均非HDL胆固醇水平为92mg / dl(2.38mmol / l),平均HDL胆固醇水平为40mg / dl(1.03mmol / l)。随机分配患者,分别每天接受100 mg的anacetrapib(15225名)或匹配的安慰剂(15224名)。主要结局是冠状动脉冠状动脉疾病、冠心病、心肌梗死或冠状动脉血运重建。

结果显示,在4.1年的中位随访期间,anacetrapib组主要结局的发生显著低于安慰剂组(1640/15402例[10.8%]VS. 1803/15,224例[11.8%];发生率比例0.91;95%置信区间,0.85-0.97;P = 0.004)。亚组中相对风险差异相似。试验中期,anacetrapib组HDL胆固醇的平均水平较安慰剂组高43mg/dl(1.12mmol/l)(相对差异为104%),非HDL胆固醇平均水平低每分升17 mg/dl(0.44 mmol/l),相对差异为-18%。死亡、癌症或其他严重不良事件风险组间差异不明显。

总之,该研究结果表明在接受强化他汀类药物治疗的动脉粥样硬化性血管疾病患者中,使用anacetrapib导致主要冠状动脉事件的发生率低于安慰剂。

原始出处:

The HPS3/TIMI55–REVEAL Collaborative Group. Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease. N Engl J Med 2017; 377:1217-1227September 28, 2017DOI: 10.1056/NEJMoa1706444.


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    2017-10-28 bsmagic9140
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    2017-11-13 AspirantSuo
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    2018-01-03 xue8602
  5. [GetPortalCommentsPageByObjectIdResponse(id=1656884, encodeId=885916568841c, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sat Oct 28 23:39:00 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1944488, encodeId=2ecb194448817, content=<a href='/topic/show?id=411de6300ad' target=_blank style='color:#2F92EE;'>#粥样硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76300, encryptionId=411de6300ad, topicName=粥样硬化)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b30d401, createdName=huangshifeng, createdTime=Sun Oct 22 03:39:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633391, encodeId=56531633391b0, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Mon Nov 13 13:39:00 CST 2017, time=2017-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005375, encodeId=57b720053e56d, content=<a href='/topic/show?id=1b141e76998' target=_blank style='color:#2F92EE;'>#TRAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17769, encryptionId=1b141e76998, topicName=TRAP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Wed Jan 03 12:39:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655802, encodeId=1100165580256, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Tue Nov 14 20:39:00 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1572980, encodeId=5d9b15e29805b, content=<a href='/topic/show?id=805d3098599' target=_blank style='color:#2F92EE;'>#冠脉疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30985, encryptionId=805d3098599, topicName=冠脉疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb3e15794072, createdName=huangshifeng, createdTime=Sun Oct 01 07:39:00 CST 2017, time=2017-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=248860, encodeId=a2c324886087, content=翻译错了.不是立普妥.而是anacetrapib, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Sep 29 20:18:49 CST 2017, time=2017-09-29, status=1, ipAttribution=)]
    2017-11-14 shanyongle
  6. [GetPortalCommentsPageByObjectIdResponse(id=1656884, encodeId=885916568841c, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sat Oct 28 23:39:00 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1944488, encodeId=2ecb194448817, content=<a href='/topic/show?id=411de6300ad' target=_blank style='color:#2F92EE;'>#粥样硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76300, encryptionId=411de6300ad, topicName=粥样硬化)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b30d401, createdName=huangshifeng, createdTime=Sun Oct 22 03:39:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633391, encodeId=56531633391b0, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Mon Nov 13 13:39:00 CST 2017, time=2017-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005375, encodeId=57b720053e56d, content=<a href='/topic/show?id=1b141e76998' target=_blank style='color:#2F92EE;'>#TRAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17769, encryptionId=1b141e76998, topicName=TRAP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Wed Jan 03 12:39:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655802, encodeId=1100165580256, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Tue Nov 14 20:39:00 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1572980, encodeId=5d9b15e29805b, content=<a href='/topic/show?id=805d3098599' target=_blank style='color:#2F92EE;'>#冠脉疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30985, encryptionId=805d3098599, topicName=冠脉疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb3e15794072, createdName=huangshifeng, createdTime=Sun Oct 01 07:39:00 CST 2017, time=2017-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=248860, encodeId=a2c324886087, content=翻译错了.不是立普妥.而是anacetrapib, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Sep 29 20:18:49 CST 2017, time=2017-09-29, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1656884, encodeId=885916568841c, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sat Oct 28 23:39:00 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1944488, encodeId=2ecb194448817, content=<a href='/topic/show?id=411de6300ad' target=_blank style='color:#2F92EE;'>#粥样硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76300, encryptionId=411de6300ad, topicName=粥样硬化)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b30d401, createdName=huangshifeng, createdTime=Sun Oct 22 03:39:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633391, encodeId=56531633391b0, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Mon Nov 13 13:39:00 CST 2017, time=2017-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2005375, encodeId=57b720053e56d, content=<a href='/topic/show?id=1b141e76998' target=_blank style='color:#2F92EE;'>#TRAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17769, encryptionId=1b141e76998, topicName=TRAP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Wed Jan 03 12:39:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655802, encodeId=1100165580256, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Tue Nov 14 20:39:00 CST 2017, time=2017-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1572980, encodeId=5d9b15e29805b, content=<a href='/topic/show?id=805d3098599' target=_blank style='color:#2F92EE;'>#冠脉疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30985, encryptionId=805d3098599, topicName=冠脉疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb3e15794072, createdName=huangshifeng, createdTime=Sun Oct 01 07:39:00 CST 2017, time=2017-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=248860, encodeId=a2c324886087, content=翻译错了.不是立普妥.而是anacetrapib, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Fri Sep 29 20:18:49 CST 2017, time=2017-09-29, status=1, ipAttribution=)]
    2017-09-29 lovetcm

    翻译错了.不是立普妥.而是anacetrapib

    0

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