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癌症患者死亡前一年他汀类药物治疗停药情况的性别差异。

Sex-Differences in Discontinuation of Statin Treatment in Cancer Patients the Year before Death.

作者信息

Frisk Gabriella, Bergström Helena, Helde Frankling Maria, Björkhem-Bergman Linda

机构信息

Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Blickagången 16, Neo Floor 7, SE-141 83 Huddinge, Sweden.

ASIH Stockholm Södra, Palliative Home Care and Hospice Ward, Bergtallsvägen 12, SE-125 59 Älvsjö, Sweden.

出版信息

Pharmaceuticals (Basel). 2021 Apr 16;14(4):368. doi: 10.3390/ph14040368.

Abstract

Statin treatment is often terminated in patients with advanced cancer but guidelines for statin discontinuation are still lacking. The aim of this study was to investigate sex-differences in time-points of statin discontinuation in patients with advanced cancer. Medical records from 1535 deceased patients enrolled at a Palliative Home Care Unit were reviewed. A total of 149 patients (42 women and 107 men) who were diagnosed with cancer, and were treated with statins one year before death, were identified. Statin treatment was terminated earlier in women than in men, 3.0 months prior to death (IQR 0.88-7.25) as compared to 1.5 months (IQR 0.5-4.0) ( < 0.05), respectively. In a longitudinal analysis there was a significant difference between men and women still on statin treatment at all studied time-points, 9, 6, and 3 months before death ( < 0.05), where women terminated statin treatment earlier in the disease trajectory. Baseline demographics were similar between the sexes except that more men than women had a history of previous cardiovascular events ( < 0.01). However, neither the indication for statin treatment, i.e., primary prevention versus secondary prevention, nor age could explain the sex-difference in statin discontinuation. There was no difference in cardiovascular events or mortality between men and women after statin discontinuation.

摘要

晚期癌症患者常常会停用他汀类药物治疗,但目前仍缺乏关于停用他汀类药物的指南。本研究的目的是调查晚期癌症患者停用他汀类药物时间点的性别差异。我们回顾了一家姑息家庭护理机构登记的1535例已故患者的病历。共识别出149例在死亡前一年被诊断为癌症并接受他汀类药物治疗的患者(42名女性和107名男性)。女性停用他汀类药物治疗的时间比男性更早,分别为死亡前3.0个月(四分位距0.88 - 7.25)和1.5个月(四分位距0.5 - 4.0)(<0.05)。在纵向分析中,在所有研究的时间点,即死亡前9个月、6个月和3个月,仍在接受他汀类药物治疗的男性和女性之间存在显著差异(<0.05),女性在疾病进程中更早停用他汀类药物。除了有既往心血管事件病史的男性多于女性(<0.01)外,两性的基线人口统计学特征相似。然而,他汀类药物治疗的指征,即一级预防与二级预防,以及年龄均无法解释停用他汀类药物的性别差异。停用他汀类药物后,男性和女性在心血管事件或死亡率方面没有差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a0e/8073177/020a45f0a94b/pharmaceuticals-14-00368-g001.jpg

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