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现实世界中瑞舒伐他汀联合非诺贝特治疗混合性血脂异常的疗效:来自哥伦比亚患者的样本研究。

Real-World Effectiveness of Therapy With Rosuvastatin Combined With Fenofibric Acid in a Sample of Colombian Patients With Mixed Dyslipidemia.

机构信息

Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia.

Grupo Biomedicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.

出版信息

J Prim Care Community Health. 2020 Jan-Dec;11:2150132720977733. doi: 10.1177/2150132720977733.

Abstract

BACKGROUND

Ischemic heart disease is the leading cause of death in the world and is associated with dyslipidemia, high blood pressure, diabetes mellitus, and other factors.

OBJECTIVE

To determine the clinical effectiveness on the lipid profile of the rosuvastatin + fenofibric acid combination in Colombian patients with high cardiovascular risk and mixed dyslipidemia.

METHODS

Longitudinal observational study in a random sample of patients with a diagnosis of mixed dyslipidemia and moderate, high, or very high cardiovascular risk who were treated with rosuvastatin + fenofibric acid. Anthropometric, clinical, laboratory, comorbidity, and pharmacological variables were identified. Effectiveness on the lipid profile was determined.

RESULTS

A total of 386 patients were analyzed. They had a mean age of 60.8 ± 11.4 years, 53.1% were female, and 75.6% had high/very high cardiovascular risk. The initial evaluation showed a mean LDL cholesterol of 138.4 ± 67.1 mg/dL and triglycerides of 679.7 ± 573.6 mg/dL. At the end of follow-up, mean LDL cholesterol was 87.5 ± 41.2 mg/dL (reduced by 43.3%;  < .001), and triglycerides were 243.5 ± 170.5 mg/dL (reduced by 64.2%;  < .001). Only 35.4% (n = 73) of patients with very high risk reached the goal of metabolic control, compared to 61.6% (n = 53) with high risk and 55.4% (n = 46) with moderate risk. Belonging to the very high-risk group was associated with a lower probability of achieving the control goal (OR: 0.32; 95%CI: 0.192-0.539).

CONCLUSION

The combination of rosuvastatin + fenofibric acid is an effective option in patients with mixed dyslipidemia and high cardiovascular risk, providing a therapeutic alternative for those conditions that require it.

摘要

背景

缺血性心脏病是世界上主要的死亡原因,与血脂异常、高血压、糖尿病等因素有关。

目的

确定在伴有高心血管风险和混合性血脂异常的哥伦比亚患者中,瑞舒伐他汀+非诺贝特联合使用对血脂谱的临床疗效。

方法

对诊断为混合性血脂异常且伴有中度、高度或极高心血管风险的患者进行随机抽样,进行纵向观察性研究,这些患者接受瑞舒伐他汀+非诺贝特治疗。确定了人体测量学、临床、实验室、合并症和药物变量。确定了对血脂谱的疗效。

结果

共分析了 386 名患者。他们的平均年龄为 60.8±11.4 岁,53.1%为女性,75.6%有高/极高心血管风险。初始评估显示 LDL 胆固醇平均为 138.4±67.1mg/dL,甘油三酯平均为 679.7±573.6mg/dL。在随访结束时,平均 LDL 胆固醇为 87.5±41.2mg/dL(降低 43.3%; < .001),甘油三酯为 243.5±170.5mg/dL(降低 64.2%; < .001)。仅有 35.4%(n=73)的极高危患者达到代谢控制目标,而高危患者为 61.6%(n=53),中危患者为 55.4%(n=46)。属于极高危组的患者达到控制目标的概率较低(OR:0.32;95%CI:0.192-0.539)。

结论

瑞舒伐他汀+非诺贝特联合使用是伴有混合性血脂异常和高心血管风险患者的有效选择,为需要的患者提供了一种治疗替代方案。

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