普伐他汀预防冠心病和大范围初始胆固醇水平患者的心血管事件和死亡
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普伐他汀预防冠心病和大范围初始胆固醇水平患者的心血管事件和死亡
中华医学杂志。1998,11(5):349- 357。doi: 10.1056 / NEJM199811053391902。
- PubMed ID
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9841303 (PubMed视图］
- 摘要
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背景:在冠心病和大范围胆固醇水平的患者中，降胆固醇治疗可降低冠状动脉事件的风险，但对冠心病死亡率和总死亡率的影响仍不确定。方法:在一项双盲随机试验中，我们比较了普伐他汀(每天40mg)和安慰剂的效果，在平均6.1年的随访期间，9014名31至75岁的患者。患者有心肌梗死史或因不稳定型心绞痛住院史，初始血浆总胆固醇水平为155 ~ 271 mg /分升。两组人都接受了降低胆固醇饮食的建议。主要研究结果为冠心病死亡率。结果:安慰剂组有8.3%的患者死于冠心病，普伐他汀组有6.4%的患者死于冠心病，风险相对降低了24%(95%置信区间，12%至35%;P < 0.001)。安慰剂组的总死亡率为14.1%，普伐他汀组为11.0%(相对风险降低22%;95%置信区间，13 - 31%;P < 0.001)。 The incidence of all cardiovascular outcomes was consistently lower among patients assigned to receive pravastatin; these outcomes included myocardial infarction (reduction in risk, 29 percent; P<0.001), death from coronary heart disease or nonfatal myocardial infarction (a 24 percent reduction in risk, P<0.001), stroke (a 19 percent reduction in risk, P=0.048), and coronary revascularization (a 20 percent reduction in risk, P<0.001). The effects of treatment were similar for all predefined subgroups. There were no clinically significant adverse effects of treatment with pravastatin. CONCLUSIONS: Pravastatin therapy reduced mortality from coronary heart disease and overall mortality, as compared with the rates in the placebo group, as well as the incidence of all prespecified cardiovascular events in patients with a history of myocardial infarction or unstable angina who had a broad range of initial cholesterol levels.
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