School of Clinical Medicine, Affiliated Hospital of Weifang Medical University, Weifang Medical University, Weifang, 261053, People's Republic of China.
Department of Cardiology, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou City, 256603, Shandong Province, People's Republic of China.
Am J Cardiovasc Drugs. 2023 Nov;23(6):695-708. doi: 10.1007/s40256-023-00606-4. Epub 2023 Sep 6.
Bempedoic acid has shown noteworthy progress in the prevention and management of atherosclerotic cardiovascular disease (ASCVD) in recent years. However, there has been a lack of high-quality evidence regarding the risk reduction of clinical events with bempedoic acid. Therefore, the aim of this article is to conduct a comprehensive evaluation of the impact of bempedoic acid on the incidence of cardiovascular events.
A systematic review and meta-analysis of randomized controlled trials pertaining to bempedoic acid was carried out. We conducted a systematic search across the Pubmed, Embase, and Cochrane Central Register of Controlled Trials databases to identify relevant studies published from inception to 23 April 2023. A total of four trials comparing the clinical benefit achieved with bempedoic acid versus placebo were included.
Our analysis comprised four trials that encompassed a total of 17,323 patients. In comparison to the placebo, bempedoic acid showed a significant reduction in the risk of major adverse cardiovascular events (MACE) [relative risk (RR), 0.86, 95% confidence interval (CI) 0.87-0.94]. Additionally, bempedoic acid substantially lowered the occurrence of fatal or nonfatal myocardial infarction (RR 0.76, 95% CI 0.66-0.89), hospitalization for unstable angina (RR 0.70, 95% CI 0.55-0.89), and coronary revascularization (RR 0.82, 95% CI 0.73-0.92). There was also a similar reduction in MACE in patients on the maximally tolerated statin therapy.
Bempedoic acid may reduce the risk of cardiovascular events regardless of whether the patient is taking stains or not.
PROSPERO registration number CRD42023422932.
近年来，贝匹地酸在预防和治疗动脉粥样硬化性心血管疾病（ASCVD）方面取得了显著进展。然而，关于贝匹地酸降低临床事件风险的高质量证据仍然缺乏。因此，本文旨在全面评估贝匹地酸对心血管事件发生率的影响。
我们对贝匹地酸的随机对照试验进行了系统评价和荟萃分析。我们对 Pubmed、Embase 和 Cochrane 中央对照试验注册库进行了系统检索，以确定截至 2023 年 4 月 23 日发表的相关研究。共纳入了四项比较贝匹地酸与安慰剂临床获益的试验。
我们的分析包括四项试验，共纳入了 17323 名患者。与安慰剂相比，贝匹地酸显著降低了主要不良心血管事件（MACE）的风险[相对风险（RR），0.86，95%置信区间（CI）0.87-0.94]。此外，贝匹地酸还显著降低了致死性或非致死性心肌梗死（RR 0.76，95% CI 0.66-0.89）、不稳定型心绞痛住院（RR 0.70，95% CI 0.55-0.89）和冠状动脉血运重建（RR 0.82，95% CI 0.73-0.92）的发生率。在最大耐受他汀类药物治疗的患者中，MACE 风险也有类似的降低。
无论患者是否服用他汀类药物，贝匹地酸都可能降低心血管事件的风险。
PROSPERO 注册号 CRD42023422932。
