AstraZeneca R&D Mölndal, Mölndal, Sweden.
Nutr Metab Cardiovasc Dis. 2012 Sep;22(9):697-703. doi: 10.1016/j.numecd.2012.03.003. Epub 2012 Jun 16.
Diabetes mellitus is a well-known risk factor for cardiovascular disease, and brings an increased risk of vascular events and a higher mortality rate. Treatment guidelines recommend statins in patients with diabetes, with low-density lipoprotein cholesterol (LDL-C) targets of 100 mg dl(-1) (∼2.5 mmol l(-1)), and 80 (∼2.0 mmol l(-1)) or 70 mg dl(-1) (∼1.8 mmol l(-1)) in especially high-risk patients. The current study used the VOYAGER (an indiVidual patient data-meta-analysis Of statin therapY in At risk Groups: Effects of Rosuvastatin, atorvastatin, and simvastatin) database to characterise effects of rosuvastatin, atorvastatin and simvastatin in different doses on lipid levels in diabetes patients.
The VOYAGER database included individual patient data from 37 studies involving comparisons of rosuvastatin with either atorvastatin or simvastatin. Of the 32 258 patients included, 8859 (27.5%) had diabetes. Rosuvastatin appeared to be the most efficacious of the three statins, both for lowering LDL-C and for reaching a target level of <70 mg dl(-1) for LDL-C. It was also more effective than atorvastatin at raising high-density lipoprotein cholesterol in the diabetes population. These results are consistent with the overall VOYAGER results.
This meta-analysis of 8859 patients with diabetes mellitus shows favourable effects on lipids with the three statins studied, in line with results for the overall VOYAGER population. The importance of using an effective statin at an effective dose to reach treatment goals for such high-risk patients is evident.
糖尿病是心血管疾病的一个已知危险因素，会增加血管事件的风险和更高的死亡率。治疗指南建议在糖尿病患者中使用他汀类药物，低密度脂蛋白胆固醇（LDL-C）目标值为 100mg/dL（2.5mmol/L），高危患者的目标值为 80（2.0mmol/L）或 70mg/dL（~1.8mmol/L）。本研究利用 VOYAGER（个体患者数据荟萃分析他汀类药物在高危人群中的治疗效果：瑞舒伐他汀、阿托伐他汀和辛伐他汀的影响）数据库，分析不同剂量的瑞舒伐他汀、阿托伐他汀和辛伐他汀对糖尿病患者血脂水平的影响。
VOYAGER 数据库包含 37 项研究的个体患者数据，这些研究比较了瑞舒伐他汀与阿托伐他汀或辛伐他汀的疗效。在纳入的 32258 例患者中，8859 例（27.5%）患有糖尿病。瑞舒伐他汀似乎是三种他汀类药物中最有效的药物，既能降低 LDL-C，又能使 LDL-C 达到<70mg/dL 的目标水平。与阿托伐他汀相比，它在提高糖尿病患者的高密度脂蛋白胆固醇方面也更有效。这些结果与总体 VOYAGER 结果一致。
这项对 8859 例糖尿病患者的荟萃分析显示，三种研究的他汀类药物对血脂均有有利影响，与总体 VOYAGER 人群的结果一致。对于这些高危患者，使用有效剂量的有效他汀类药物达到治疗目标非常重要。
