Cucherat M, Boissel J P, Collet J P
Unité de pharmacologie clinique, hôpital neuro-cardiologique, Lyon.
Arch Mal Coeur Vaiss. 1992 Sep;85 Spec No 2:105-8.
The prevention of lipid-related coronary risk by lipid lowering drugs or diet has been the object of several therapeutic trials. This meta-analysis comprises the 6 available primary prevention trials (representing 30,695 subjects). There was an overall reduction of non-lethal infarcts (-26%) and coronary events (-18%) in the treatment groups. There was a tendency to less coronary deaths (-10%), though not statistically significant, and no difference in mortality due to all causes was observed. Some questions remain unanswered about the fact that the reduced incidence of ischaemic heart disease did not affect global mortality. This fact could be explained by an inadequate duration of treatment or follow-up, to an effect limited to chronic infarction or to eventual unidentified adverse effects (the meta-analysis does not show any significant differences in mortality due to cancer or accidental death).
通过降脂药物或饮食预防脂质相关的冠心病风险一直是多项治疗试验的目标。这项荟萃分析纳入了6项可用的一级预防试验（涉及30695名受试者）。治疗组中非致死性梗死（-26%）和冠心病事件（-18%）总体有所减少。虽然冠状动脉死亡有减少趋势（-10%），但无统计学意义，且未观察到全因死亡率有差异。关于缺血性心脏病发病率降低却未影响总体死亡率这一事实，仍有一些问题未得到解答。这一事实可解释为治疗或随访时间不足、作用仅限于慢性梗死或存在最终未识别的不良反应（荟萃分析未显示癌症或意外死亡导致的死亡率有任何显著差异）。
