Department of Aged Care, Stroke and Rehabilitation, Bankstown-Lidcombe Hospital, Sydney, Australia.
Acta Neurol Scand. 2011 Sep;124(3):188-95. doi: 10.1111/j.1600-0404.2010.01450.x. Epub 2010 Oct 27.
To evaluate the efficacy of intensive lipid lowering with higher-dose statins.
Meta-analysis of seven randomized controlled trials comprising 50,972 participants.
Mean follow-up was 3.1 years with mean age 63 years. Final LDL-C levels in intensive lipid-lowering group were 1.42-2.07 mmol/l compared to 2.1-3.5 mmol/l in the less intensive or control group. The intensive arm had significantly lower risks for stroke OR 0.80 (95% CI 0.71-0.89); major coronary events OR 0.74 (95% CI 0.65-0.83); cardiovascular disease (CVD) or coronary heart disease (CHD) deaths OR 0.84 (95% CI 0.74-0.95). Significantly higher liver enzyme abnormalities occurred in intensive group* (OR 3.96; 95% CI 2.08-7.53), but it was not associated with drug discontinuations (OR 1.20; 95% CI 0.88-1.64).
In those at high risk of cardiovascular events, intensive lipid lowering with statins to LDL-C level <2.1 mmol/l significantly reduces risk of stroke, major coronary events and CVD or CHD deaths compared to LDL-C level ≥ 2.1 mmol/l. [*Correction added on 11 January 2011 after first online publication on 27 October 2010. The phrase, "Significantly higher liver enzyme abnormalities occurred in less intensive group", was amended to "Significantly higher liver enzyme abnormalities occurred in intensive group".].
评估高剂量他汀类药物强化降脂的疗效。
对包含 50972 名参与者的 7 项随机对照试验进行荟萃分析。
平均随访 3.1 年，平均年龄 63 岁。强化降脂组的最终 LDL-C 水平为 1.42-2.07mmol/L，而低强度降脂组或对照组的 LDL-C 水平为 2.1-3.5mmol/L。强化降脂组发生卒中的风险显著降低（OR 0.80，95%CI 0.71-0.89）；主要冠状动脉事件（OR 0.74，95%CI 0.65-0.83）；心血管疾病（CVD）或冠心病（CHD）死亡（OR 0.84，95%CI 0.74-0.95）的风险显著降低。强化降脂组肝酶异常发生率显著升高（OR 3.96，95%CI 2.08-7.53），但与药物停药无关（OR 1.20，95%CI 0.88-1.64）。
对于心血管事件高危人群，将他汀类药物降低 LDL-C 水平至<2.1mmol/L 的强化降脂治疗与 LDL-C 水平≥2.1mmol/L 相比，可显著降低卒中、主要冠状动脉事件和 CVD 或 CHD 死亡的风险。[*2011 年 1 月 11 日更正：在 2010 年 10 月 27 日首次在线发表后。短语“低强度降脂组肝酶异常发生率更高”被修正为“强化降脂组肝酶异常发生率更高”。]
