Goyal Aman, Tariq Muhammad Daoud, Jain Hritvik, Shrestha Abhigan Babu, Fatima Laveeza, Riyaz Romana, Yadav Hritik Raj, Safi Darsh, Yasinzai Abdul Qahar K, Khan Rozi, Sohail Amir Humza, Daoud Mohamed, Sheikh Abu Baker
Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India.
Foundation University Medical College, Islamabad, Pakistan.
Cardiovasc Endocrinol Metab. 2024 Oct 25;13(4):e00315. doi: 10.1097/XCE.0000000000000315. eCollection 2024 Dec.
Cardiovascular disease is a leading cause of mortality, especially in individuals with type 2 diabetes mellitus and dyslipidemia. Despite adequate statin therapy, some patients fail to achieve the target low-density lipoprotein-cholesterol levels. Trials have compared doubling the statin dose with the addition of ezetimibe. A systematic literature search was performed using various databases. Forest plots were constructed for pooled analysis with statistical significance set at < 0.05. Seven trials were included. Monotherapy showed no significant difference compared with dual therapy for low-density lipoprotein-cholesterol levels [mean difference (MD): -5.03; = 0.37], high-density lipoprotein-cholesterol levels (MD: 0.01; = 0.95), total cholesterol (MD: -2.38; = 0.66), and triglycerides (MD: 5.37; = 0.67) at follow-up compared to baseline. Monotherapy significantly reduced serious clinical adverse events (risk ratio: 0.21; = 0.04), with no difference in treatment-related adverse effects, discontinuation due to treatment-related or overall adverse events.
心血管疾病是主要的死亡原因，尤其在2型糖尿病和血脂异常患者中。尽管他汀类药物治疗充分，但一些患者仍未能达到目标低密度脂蛋白胆固醇水平。试验比较了他汀类药物剂量加倍与加用依折麦布的效果。使用各种数据库进行了系统的文献检索。构建森林图进行汇总分析，设定统计学显著性为<0.05。纳入了7项试验。与双联疗法相比，单药治疗在随访时的低密度脂蛋白胆固醇水平[平均差(MD)：-5.03；P = 0.37]、高密度脂蛋白胆固醇水平(MD：0.01；P = 0.95)、总胆固醇(MD：-2.38；P = 0.66)和甘油三酯(MD：5.37；P = 0.67)方面与基线相比无显著差异。单药治疗显著降低了严重临床不良事件(风险比：0.21；P = 0.04)，在治疗相关不良反应、因治疗相关或总体不良事件导致的停药方面无差异。
