Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, People's Republic of China.
Nat Commun. 2024 Nov 15;15(1):9922. doi: 10.1038/s41467-024-54078-4.
Little is known about the long-term effectiveness of risk-based treat-to-target cholesterol-lowering interventions on cardiovascular risk. Here, we show the emulated effectiveness of guideline-recommended low-density and non-high-density lipoprotein cholesterol-lowering interventions using the absolute risk reduction (ARR) and the restricted mean event-free time-based number needed to treat (NNT). With 5,375 participants, the 29-year risks for cardiovascular disease (CVD), all-cause mortality, and atherosclerotic CVD were 18.6%, 25.6%, and 17.7%, respectively. Long-term treat-to-target interventions showed significant reductions in CVD (ARR -2.3%, 95%CI -3.4% to -0.8%; NNT 115), all-cause mortality (-3.0%, -4.3% to -1.8%; 95), and atherosclerotic CVD (-2.6%, -3.5% to -1.2%; 104). Such effects appear more pronounced in women, smokers, and those with body mass index < 24 kg/m² or higher adherence rates.
关于基于风险的达标降脂干预措施对心血管风险的长期效果知之甚少。在这里，我们使用绝对风险降低（ARR）和基于限制平均无事件时间的所需治疗人数（NNT）来显示指南推荐的降低低密度脂蛋白和非高密度脂蛋白胆固醇的干预措施的模拟效果。在 5375 名参与者中，心血管疾病（CVD）、全因死亡率和动脉粥样硬化性 CVD 的 29 年风险分别为 18.6%、25.6%和 17.7%。长期达标治疗干预可显著降低 CVD（ARR -2.3%，95%CI -3.4%至-0.8%；NNT 115）、全因死亡率（-3.0%，-4.3%至-1.8%；95）和动脉粥样硬化性 CVD（-2.6%，-3.5%至-1.2%；104）。这些效果在女性、吸烟者以及体重指数<24 kg/m²或更高依从率的人群中更为明显。
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