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印度首次发生急性冠状动脉事件的成年人中的他汀类药物治疗/降脂治疗:尽管接受他汀类药物治疗仍存在血脂异常残留和混合异常(REMAINS)研究。

Statin therapy/lipid lowering therapy among Indian adults with first acute coronary event: The dyslipidemia Residual and Mixed Abnormalities IN spite of Statin therapy (REMAINS) study.

作者信息

Jaywant Salgaonkar V, Singh A K, Prabhu Mundkur S, Ranjan R

机构信息

Associate Director, Medical Affairs, MSD, India.

Senior Specialist, MSD, India.

出版信息

Indian Heart J. 2016 Sep-Oct;68(5):646-654. doi: 10.1016/j.ihj.2015.12.016. Epub 2016 Feb 28.

Abstract

OBJECTIVE

The primary objective was to evaluate the effect of statin therapy/lipid lowering therapy (LLT) on lipid profile, in adults presenting with first acute coronary event.

METHODS AND MATERIAL

A multicentre, observational, prospective cohort study of lipid profiles pre- and post-statin therapy/LLT, among adult patients with confirmed diagnosis of first acute coronary event. The primary outcome measures were low-density lipoprotein cholesterol (LDL-C) in mg/dl, high-density lipoprotein cholesterol (HDL-C) in mg/dl and triglycerides (TG) in mg/dl at baseline and end of study (EOS, 12 weeks [mean: 13.5 weeks]).

RESULTS

Totally 474 patients completed the study. Number of patients with any LDL-C abnormality (LDL-C [all; LDL was abnormal, either alone or along with other lipid parameter(s)]) decreased from 118 (24.9%) to 27 (5.7%), and for LDL-C (only; only the LDL was abnormal), from 46 (9.7%) to 13 (2.7%), both from baseline to EOS. Of 118 patients with high LDL-C (all) at baseline, 91 (77.1%) had reduction in LDL-C to <100mg/dl, of which 54 (45.8%) had LDL-C <70mg/dl at EOS. The patients with LDL-C fraction abnormalities decreased, while HDL-C abnormalities increased at EOS from baseline. No major difference was observed at baseline and EOS in levels of TG (all [TG was abnormal, either alone or along with other lipid parameter(s)]) and TG (only [only the TG was abnormal]). Six (1.3%) had seven serious adverse events.

CONCLUSIONS

Though statin therapy is effective in lowering LDL-C, there still remains residual dyslipidemia, which probably should be tackled with therapeutic and non-therapeutic options.

摘要

目的

主要目的是评估他汀类药物治疗/降脂治疗(LLT)对首次发生急性冠状动脉事件的成年人血脂谱的影响。

方法和材料

一项多中心、观察性、前瞻性队列研究,对确诊为首次急性冠状动脉事件的成年患者在他汀类药物治疗/LLT前后的血脂谱进行研究。主要结局指标为基线时和研究结束时(EOS,12周[平均:13.5周])的低密度脂蛋白胆固醇(LDL-C,单位为mg/dl)、高密度脂蛋白胆固醇(HDL-C,单位为mg/dl)和甘油三酯(TG,单位为mg/dl)。

结果

共有474例患者完成了研究。从基线到EOS,任何LDL-C异常(LDL-C[全部;LDL异常,单独或与其他血脂参数一起])的患者数量从118例(24.9%)降至27例(5.7%),LDL-C(仅;仅LDL异常)的患者数量从46例(9.7%)降至13例(2.7%)。在基线时LDL-C(全部)升高的118例患者中,91例(77.1%)的LDL-C降至<100mg/dl,其中54例(45.8%)在EOS时LDL-C<70mg/dl。LDL-C部分异常的患者减少,而HDL-C异常在EOS时较基线时增加。基线时和EOS时甘油三酯(全部[甘油三酯异常,单独或与其他血脂参数一起])和甘油三酯(仅[仅甘油三酯异常])水平未观察到重大差异。6例(1.3%)发生了7起严重不良事件。

结论

尽管他汀类药物治疗在降低LDL-C方面有效,但仍存在残余血脂异常,可能需要通过治疗和非治疗手段来解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb2c/5079128/3fbe2d057635/gr1.jpg

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