瑞舒伐他汀预防c反应蛋白升高的男性和女性血管事件。
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Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ
瑞舒伐他汀预防c反应蛋白升高的男性和女性血管事件。
中华医学杂志，2008,31(2):397 - 397。doi: 10.1056 / NEJMoa0807646。Epub 2008 11月9日
- PubMed ID
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18997196 (PubMed视图］
- 摘要
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背景:炎症生物标志物高敏感性c反应蛋白水平升高可预测心血管事件。由于他汀类药物降低了高敏c反应蛋白和胆固醇的水平，我们假设高敏c反应蛋白水平升高但没有高脂血症的人可能从他汀类药物治疗中受益。方法:我们随机分配17802名明显健康的男性和女性，低密度脂蛋白(LDL)胆固醇水平低于130毫克/分升(3.4 mmol /升)，高敏c反应蛋白水平为2.0毫克/升或更高，分别服用瑞舒伐他汀、每天20毫克或安慰剂，并跟踪观察他们发生心肌梗死、中风、动脉血运重建、不稳定型心绞痛住院或心血管原因死亡的合并主要终点。结果:该试验在中位随访1.9年(最长随访5.0年)后停止。瑞舒伐他汀降低了50%的LDL胆固醇水平和37%的高敏c反应蛋白水平。瑞舒伐他汀组和安慰剂组的主要终点率分别为每100人-年随访0.77和1.36(瑞舒伐他汀的风险比为0.56;95%置信区间[CI]， 0.46 ~ 0.69;P<0.00001)，心肌梗死的风险比分别为0.17和0.37(风险比0.46;95% CI, 0.30 ~ 0.70; P=0.0002), 0.18 and 0.34 for stroke (hazard ratio, 0.52; 95% CI, 0.34 to 0.79; P=0.002), 0.41 and 0.77 for revascularization or unstable angina (hazard ratio, 0.53; 95% CI, 0.40 to 0.70; P<0.00001), 0.45 and 0.85 for the combined end point of myocardial infarction, stroke, or death from cardiovascular causes (hazard ratio, 0.53; 95% CI, 0.40 to 0.69; P<0.00001), and 1.00 and 1.25 for death from any cause (hazard ratio, 0.80; 95% CI, 0.67 to 0.97; P=0.02). Consistent effects were observed in all subgroups evaluated. The rosuvastatin group did not have a significant increase in myopathy or cancer but did have a higher incidence of physician-reported diabetes. CONCLUSIONS: In this trial of apparently healthy persons without hyperlipidemia but with elevated high-sensitivity C-reactive protein levels, rosuvastatin significantly reduced the incidence of major cardiovascular events. (ClinicalTrials.gov number, NCT00239681.)
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