Marrs Joel C, Kostoff Matthew D
Skaggs School of Pharmacy and Pharmaceutical Sciences, Department of Clinical Pharmacy, University of Colorado, Mail Stop C238, 12850 E. Montview Blvd., Room V20-2128, Aurora, CO, 80045, USA.
Department of Pharmacy Practice, Wichita Campus, University of Kansas School of Pharmacy, 1010 N. Kansas Avenue, Wichita, KS, 67214, USA.
Curr Atheroscler Rep. 2016 Jul;18(7):41. doi: 10.1007/s11883-016-0596-z.
The key benefits of statin therapy have been well established in both primary and secondary prevention cardiovascular patients. Many studies have shown a significant statin discontinuation rate within the first year of initiation whether for primary or secondary prevention. National guidelines for the management of dyslipidemia highlight the lack of benefit seen with statin therapy in patients with chronic kidney disease receiving dialysis, heart failure with reduced ejection fraction, and patients greater than 75 years of age without atherosclerotic cardiovascular disease. Available data outside of these patient populations do not support discontinuation of statin therapy. Recent studies support an association with statin discontinuation and increased risk of myocardial infarction and cardiovascular death. Based on the available data, discontinuation of statin therapy should be carefully considered.
他汀类药物治疗的关键益处已在心血管疾病的一级和二级预防患者中得到充分证实。许多研究表明，无论是一级预防还是二级预防，在开始治疗的第一年内，他汀类药物的停药率都很高。血脂异常管理的国家指南强调，接受透析的慢性肾病患者、射血分数降低的心力衰竭患者以及年龄大于75岁且无动脉粥样硬化性心血管疾病的患者，他汀类药物治疗未见益处。这些患者群体之外的现有数据不支持停用他汀类药物治疗。最近的研究支持他汀类药物停药与心肌梗死和心血管死亡风险增加之间存在关联。基于现有数据，应谨慎考虑停用他汀类药物治疗。
