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新的欧洲心血管疾病预防指南具有误导性。

The new European guidelines for prevention of cardiovascular disease are misleading.

机构信息

Magle Stora Kyrkogata 9 , Lund, Sweden.

Prince Sultan Cardiac Center , Hofuf, Alhasar, Saudi Arabia.

出版信息

Expert Rev Clin Pharmacol. 2020 Dec;13(12):1289-1294. doi: 10.1080/17512433.2020.1841635. Epub 2021 Jan 8.

Abstract

: The European Society of Cardiology and European Atherosclerosis Society (ESC/EAS) have recently published three major revisions of their guidelines for the management of chronic heart disease, blood lipids, and diabetes. : We have scrutinized these guidelines in detail and found that the authors have ignored many studies that are in conflict with their conclusions and recommendations. : The authors of the guidelines have ignored that LDL-cholesterol (LDL-C) of patients with acute myocardial infarction is lower than normal; that high cholesterol is not a risk factor for diabetics; that the degree of coronary artery calcification is not associated with LDL-C; and that 27 follow-up studies have shown that people with high total cholesterol or LDL-C live just as long or longer than people with low cholesterol. They have also ignored the lack of exposure-response in the statin trials; that several of these trials have been unable to lower CVD or total mortality; that no statin trial has succeeded with lowering mortality in women, elderly people, or diabetics; and that cholesterol-lowering with statins has been associated with many serious side effects.

摘要

: 欧洲心脏病学会和欧洲动脉粥样硬化学会(ESC/EAS)最近发布了其关于慢性心脏病、血脂和糖尿病管理的三项主要指南修订版。: 我们对这些指南进行了详细审查,发现作者忽略了许多与他们的结论和建议相矛盾的研究。: 指南的作者忽略了急性心肌梗死患者的 LDL 胆固醇(LDL-C)低于正常水平;高胆固醇不是糖尿病患者的风险因素;冠状动脉钙化程度与 LDL-C 无关;27 项随访研究表明,总胆固醇或 LDL-C 水平高的人寿命与胆固醇水平低的人一样长或更长。他们还忽略了他汀类药物试验中缺乏暴露-反应关系;这些试验中有几个未能降低心血管疾病或总死亡率;没有一项他汀类药物试验成功降低女性、老年人或糖尿病患者的死亡率;他汀类药物降低胆固醇与许多严重的副作用有关。

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