Gutierrez Jose, Ramirez Gilbert, Rundek Tatjana, Sacco Ralph L
Department of Neurology, Neurological Institute, Columbia University, New York, New York 10032, USA.
Arch Intern Med. 2012 Jun 25;172(12):909-19. doi: 10.1001/archinternmed.2012.2145.
The effect of statins on the prevention of cardiovascular events is well demonstrated. Whether this protective effect is equal for women and men remains less well established. Our objective was to evaluate if statin therapy is equally effective in decreasing recurrent cardiovascular events in women and men.
Randomized clinical trials were searched in PubMed using as indexing terms (statins OR cholesterol lowering medications) AND (cardiovascular events OR stroke OR myocardial infarction OR cardiovascular death).
We included randomized, double-blinded, placebo-controlled trials evaluating statins for secondary prevention of cardiovascular events. Studies with an open-label design and observational studies were excluded.
The earliest citation was used to determine the characteristic of the studied population and the methodology. All subsequent citations corresponding to the trial were evaluated for outcome rates by sex.
Eleven trials representing 43,193 patients were included in the analysis. Overall, statin therapy was associated with a reduced risk of cardiovascular events in all outcomes for women (relative risk [RR], 0.81 [95% CI, 0.74-0.89]) and men (RR, 0.82 [95% CI, 0.78-0.85]). However, they did not reduce all-cause mortality in women vs men (RR, 0.92 [95% CI, 0.76-1.13] vs RR, 0.79 [95% CI, 0.720.87]) or stroke (RR, 0.92 [95% CI, 0.76-1.10] vs RR, 0.81 [95% CI, 0.72-0.92]).
Statin therapy is an effective intervention in the secondary prevention of cardiovascular events in both sexes, but there is no benefit on stroke and all-cause mortality in women.
他汀类药物对预防心血管事件的作用已得到充分证实。但这种保护作用在女性和男性中是否相同仍不太明确。我们的目的是评估他汀类药物治疗在降低女性和男性复发性心血管事件方面是否同样有效。
在PubMed中检索随机临床试验，检索词为（他汀类药物或降胆固醇药物）以及（心血管事件或中风或心肌梗死或心血管死亡）。
我们纳入了评估他汀类药物用于心血管事件二级预防的随机、双盲、安慰剂对照试验。排除开放标签设计的研究和观察性研究。
最早的引文用于确定研究人群的特征和方法。对该试验的所有后续引文按性别评估结局发生率。
分析纳入了11项试验，共43193例患者。总体而言，他汀类药物治疗与女性（相对风险[RR]，0.81[95%CI，0.74 - 0.89]）和男性（RR，0.82[95%CI，0.78 - 0.85]）所有结局的心血管事件风险降低相关。然而，在降低全因死亡率方面，女性（RR，0.92[95%CI，0.76 - 1.13]）与男性（RR，0.79[95%CI，0.72 - 0.87]）不同，在降低中风方面（RR，0.92[95%CI，0.76 - 1.10]）与男性（RR，0.81[95%CI，0.72 - 0.92]）也不同。
他汀类药物治疗是男女心血管事件二级预防的有效干预措施，但对女性中风和全因死亡率无益处。
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