他汀类药物对不同心血管疾病患者血脂谱的影响：一项随机临床试验的系统评价与荟萃分析

Effect of Statins on the Blood Lipid Profile in Patients with Different Cardiovascular Diseases: A Systematic Review with Meta-analysis of Randomized Clinical Trials.

作者信息

Aslani Saeed, Razi Bahman, Imani Danyal, Mohammadi Keyhan, Jamialahmadi Tannaz, Reiner Željko, Sahebkar Amirhossein

机构信息

Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Department of Hematology, School of Medicine, Tarbiat Modares University, Tehran, Iran.

出版信息

Curr Med Chem. 2023;30(32):3702-3724. doi: 10.2174/0929867330666221129094921.

DOI:10.2174/0929867330666221129094921

PMID:36453499

Abstract

BACKGROUND

Statins are the main lipid-lowering drugs and are used in the prevention of cardiovascular diseases (CVDs). Since the results have been, to some extent, inconsistent in the clinical trials concerning different types of CVDs, a systematic review and meta-analysis was performed to prove the effect of statins on decreasing elevated levels of total cholesterol, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in patients with CVDs.

METHODS

Literature search was performed on major electronic databases (MEDLINE/ PubMed, Scopus, and ISI Web of Science) from inception up to July 2021 to find randomized controlled trials (RCTs) evaluating the effect of different statins on different types of CVDs. The effect size was determined using weighted mean difference (WMD) and corresponding 95% confidence interval (CI).

RESULTS

Statin therapy significantly decreased levels of total cholesterol (WMD = -33.37 mg/dl, 95% CI: -45.98 to -20.76, P<0.001), LDL-C (WMD = -29.42 mg/dl, 95% CI: -36.81 to -22.03, P<0.001), and TG (WMD = -15.19 mg/dl, 95% CI = -26.41 to -3.97, P<0.001), and increased levels of HDL-C (WMD = 1.55 mg/dl, 95% CI: 0.20, to 2.90, P=0.02) in patients with different CVDs.

CONCLUSION

Statin therapy was found effective in lowering levels of total cholesterol, LDL-C, and TG, and increasing levels of HDL-C in patients with different CVDs.

摘要

背景

他汀类药物是主要的降脂药物，用于预防心血管疾病（CVD）。由于在不同类型心血管疾病的临床试验中，结果在一定程度上存在不一致性，因此进行了一项系统评价和荟萃分析，以证实他汀类药物对降低心血管疾病患者总胆固醇、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）升高水平的效果。

方法

在主要电子数据库（MEDLINE/ PubMed、Scopus和ISI Web of Science）中进行文献检索，检索时间从建库至2021年7月，以查找评估不同他汀类药物对不同类型心血管疾病效果的随机对照试验（RCT）。使用加权平均差（WMD）和相应的95%置信区间（CI）确定效应量。

结果

他汀类药物治疗显著降低了不同心血管疾病患者的总胆固醇水平（WMD = -33.37 mg/dl，95% CI：-45.98至-20.76，P<0.001）、LDL-C水平（WMD = -29.42 mg/dl，95% CI：-36.81至-22.03，P<0.001）和TG水平（WMD = -15.19 mg/dl，95% CI = -26.41至-3.97，P<0.001），并提高了HDL-C水平（WMD = 1.55 mg/dl，95% CI：0.20至2.90，P = 0.02）。