Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea.
Department of Information & Statistics, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea.
PLoS One. 2021 Feb 25;16(2):e0247419. doi: 10.1371/journal.pone.0247419. eCollection 2021.
Statins have been recommended for use in atherosclerotic cardio-cerebrovascular disease (CCVD). The purpose of this study was to investigate the efficacy of five different types of statin in the secondary prevention of CCVD in patients. This study retrospectively designed and analyzed data from the National Health Insurance Service-National Health in Korea. Participants aged 40 to 69 years were categorized into five statin groups (atorvastatin, rosuvastatin, pitavastatin, simvastatin, and pravastatin). The primary composite outcome was defined as recurrence of CCVD or all causes of death. Cox proportional hazard regression models were adopted after stepwise adjustments for confounders to investigate the difference in efficacy among the different statins. Of the 755 final participants, 48 patients experienced primary composite outcomes. After adjustments, the hazard ratios (95% confidence intervals) for primary composite outcomes of atorvastatin, pitavastatin, and rosuvastatin groups were 0.956 (0.456-2.005), 1.347 (0.354-5.116), and 0.943 (0.317-2.803), respectively, when compared with the simvastatin group. There were no significant differences between the statins in efficacy for preventing recurrence of CCVD events and/or death in CCVD patients.
他汀类药物已被推荐用于动脉粥样硬化性心脑血管疾病（CCVD）的防治。本研究旨在探讨五种不同类型的他汀类药物在 CCVD 患者二级预防中的疗效。本研究采用回顾性设计，对韩国国家健康保险服务-国家健康保险数据库中的数据进行了分析。参与者年龄在 40 至 69 岁之间，分为五组他汀类药物（阿托伐他汀、瑞舒伐他汀、匹伐他汀、辛伐他汀和普伐他汀）。主要复合结局定义为 CCVD 复发或全因死亡。采用 Cox 比例风险回归模型，在逐步调整混杂因素后，对不同他汀类药物的疗效差异进行了探讨。在 755 名最终参与者中，有 48 名患者发生了主要复合结局。调整后，与辛伐他汀组相比，阿托伐他汀、匹伐他汀和瑞舒伐他汀组的主要复合结局的风险比（95%置信区间）分别为 0.956（0.456-2.005）、1.347（0.354-5.116）和 0.943（0.317-2.803）。在预防 CCVD 事件复发和/或 CCVD 患者死亡方面，他汀类药物之间的疗效没有显著差异。
