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高危他汀不耐受患者使用苯扎贝特酸的心血管结局风险:系统评价和荟萃分析。

Risk of cardiovascular outcomes with bempedoic acid in high-risk statin intolerant patients: a systematic review and meta analysis.

机构信息

Federal Medical & Dental College (FMDC), Al-Farabi Center, Hanna Road, G-8/4, Islamabad, 44080, Pakistan.

Quaid-e-Azam Medical College, Circular Road, Bahawalpur, 63100, Pakistan.

出版信息

Future Cardiol. 2024;20(11-12):639-650. doi: 10.1080/14796678.2024.2388478. Epub 2024 Aug 14.


DOI:10.1080/14796678.2024.2388478
PMID:39140596
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11520570/
Abstract

Statin intolerance and myopathy is a major issue with prolonged use of statins myopathy. Bempedoic acid can be a good alternative for those intolerant to statins. This systematic review aims to observe incidence of major adverse cardiovascular events (MACE) and other adverse events, in high-risk statin intolerant patients receiving bempedoic acid. Literature search was conducted via Google Scholar, Science Direct and PubMed, after which screening, selection and data extraction of articles was done. Meta-analysis was performed on RevMan 5.4. Subgroup analysis was also conducted and heterogeneity was evaluated. Risk of bias was performed using ROB2 assessment scale. (CRD42024536827). Only six randomized controlled trials were used in final analysis consisting of 17,844 patients. Treatment with bempedoic acid was associated with a reduced risk of MACE compared with placebo (RR 0.86; 95% CI [0.79, 0.94]  = 0.0005), with myocardial infarction significantly reduced. Incidence of adverse effects was increased with bempedoic acid (RR: 1.02; 95% [1.00, 1.03]  = 0.01) but no significant difference was observed. Incidence of myalgia was reduced in bempedoic group as well. Bempedoic acid is a safe and effective alternative to statins in high-risk patients intolerant to statins, decreasing the risk of MACE.

摘要

他汀类药物不耐受和肌病是长期使用他汀类药物肌病的一个主要问题。贝匹地酸可以作为不耐受他汀类药物的患者的良好替代品。本系统评价旨在观察不耐受他汀类药物的高危患者接受贝匹地酸治疗后主要不良心血管事件(MACE)和其他不良事件的发生率。通过谷歌学术、科学直接和 PubMed 进行文献检索,然后对文章进行筛选、选择和数据提取。使用 RevMan 5.4 进行荟萃分析。还进行了亚组分析并评估了异质性。使用 ROB2 评估量表进行偏倚风险评估。(CRD42024536827)。最终分析仅使用了六项随机对照试验,共纳入 17844 名患者。与安慰剂相比,贝匹地酸治疗与 MACE 风险降低相关(RR 0.86;95%CI [0.79, 0.94]  = 0.0005),心肌梗死显著减少。贝匹地酸治疗的不良反应发生率增加(RR:1.02;95%[1.00, 1.03]  = 0.01),但无显著差异。贝匹地酸组肌痛发生率也降低。对于不耐受他汀类药物的高危患者,贝匹地酸是一种安全有效的他汀类药物替代品,可以降低 MACE 的风险。

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Risk of cardiovascular outcomes with bempedoic acid in high-risk statin intolerant patients: a systematic review and meta analysis.

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本文引用的文献

[1]
Safety and efficacy of bempedoic acid among patients with statin intolerance and those without: A meta-analysis and a systematic randomized controlled trial review.

PLoS One. 2024

[2]
Efficacy and outcomes of Bempedoic acid versus placebo in patients with statin-intolerance: A pilot systematic review and meta-analysis of randomized controlled trials.

Curr Probl Cardiol. 2024-2

[3]
Effectiveness of lipid-lowering therapy on mortality and major adverse cardiovascular event outcomes in patients undergoing percutaneous coronary intervention: a network meta-analysis of randomised controlled trials.

BMJ Open. 2023-11-15

[4]
Efficacy and safety of bempedoic acid lipid-lowering therapy: a systematic review and meta-analysis of randomized controlled trials.

Eur J Clin Pharmacol. 2023-11

[5]
Clinical Benefit of Bempedoic Acid in Randomized Clinical Trials.

Am J Cardiol. 2023-10-15

[6]
Bempedoic acid in the management of lipid disorders and cardiovascular risk. 2023 position paper of the International Lipid Expert Panel (ILEP).

Prog Cardiovasc Dis. 2023

[7]
Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients.

N Engl J Med. 2023-4-13

[8]
Estimated cardiovascular benefits of bempedoic acid in patients with established cardiovascular disease.

Atheroscler Plus. 2022-5-28

[9]
Potential Cardiovascular Events Avoided with Bempedoic Acid Plus Ezetimibe Fixed-Dose Combination Compared with Ezetimibe Alone in Patients with Atherosclerotic Cardiovascular Disease Taking Maximally Tolerated Statins.

Am J Cardiovasc Drugs. 2023-1

[10]
Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials.

Lancet. 2022-9-10

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