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他汀类药物用于心力衰竭:我们还需要另一项试验吗?

Statins in heart failure: do we need another trial?

作者信息

Bonsu Kwadwo Osei, Kadirvelu Amudha, Reidpath Daniel Diamond

机构信息

School of Medicine and Health Sciences, Monash University Sunway Campus, Bandar Sunway, Malaysia.

出版信息

Vasc Health Risk Manag. 2013;9:303-19. doi: 10.2147/VHRM.S44499. Epub 2013 Jun 17.

Abstract

Statins lower serum cholesterol and are employed for primary and secondary prevention of cardiovascular events. Clinical evidence from observational studies, retrospective data, and post hoc analyses of data from large statin trials in various cardiovascular conditions, as well as small scale randomized trials, suggest survival and other outcome benefits for heart failure. Two recent large randomized controlled trials, however, appear to suggest statins do not have beneficial effects in heart failure. In addition to lowering cholesterol, statins are believed to have many pleotropic effects which could possibly influence the pathophysiology of heart failure. Following the two large trials, evidence from recent studies appears to support the use of statins in heart failure. This review discusses the role of statins in the pathophysiology of heart failure, current evidence for statin use in heart failure, and suggests directions for future research.

摘要

他汀类药物可降低血清胆固醇,用于心血管事件的一级和二级预防。来自观察性研究、回顾性数据以及各种心血管疾病中大型他汀类药物试验的事后分析和小规模随机试验的临床证据表明,他汀类药物对心力衰竭患者的生存及其他预后有益。然而,最近两项大型随机对照试验似乎表明,他汀类药物对心力衰竭并无有益作用。除了降低胆固醇外,他汀类药物还被认为具有多种多效性作用,可能会影响心力衰竭的病理生理学。在这两项大型试验之后,近期研究的证据似乎支持在心力衰竭中使用他汀类药物。本文综述了他汀类药物在心力衰竭病理生理学中的作用、目前他汀类药物用于心力衰竭的证据,并提出了未来研究的方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9aa6/3688443/5aca322fc994/vhrm-9-303Fig1.jpg

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