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首页> 外文期刊>Pulmonary Circulation >A Systematic Review and Meta-Analysis of Trials Using Statins in Pulmonary Arterial Hypertension:
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A Systematic Review and Meta-Analysis of Trials Using Statins in Pulmonary Arterial Hypertension:

机译：使用他汀类药物治疗肺动脉高压的系统评价和荟萃分析：

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Statins improve pulmonary vascular remodeling and right ventricular hypertrophy in animal models of pulmonary arterial hypertension (PAH). However, clinical trials assessing the efficacy of statins in patients with PAH have reported mixed results. In this systematic review and meta-analysis, we assess the efficacy of statins in patients with PAH. We included randomized controlled clinical trials (RCTs) that evaluated the efficacy of statins in patients with PAH. Primary outcomes were mortality and change in 6-minute walk distance (6MWD). Data are presented as odds ratio (OR) and weighted mean difference (WMD), with 95% confidence intervals (CIs), for binary and continuous variables, respectively. We included 4 RCTs of high quality. The mean age of participants was 42 ± 13 years, and 70% were women. The statins used were simvastatin at 40–80 mg in two trials, atorvastatin 10 mg in one trial, and rosuvastatin 10 mg in the other. In the pooled-data analysis, there was no statistically significant improvement in mortality (OR: 0.75 [95% CI: 0.32–1.74]), 6MWD (WMD: ?9.27 [95% CI: ?27.73 to 9.20]), or cardiac index (WMD: 0.11 [95% CI: ?0.04 to 0.27]) with statin therapy when compared to placebo. There was no difference in adverse events leading to withdrawal of therapy between statin and placebo groups. These data suggest that statins are not beneficial in the treatment of PAH. There is a need for large, well-conducted clinical trials assessing the effects of statins in patients with PAH. Future trials should include homogeneous patient populations and should be long-term, event-driven trials with combined morbidity and mortality end points.
机译：他汀类药物可改善肺动脉高压（PAH）动物模型中的肺血管重构和右室肥大。但是，评估他汀类药物在PAH患者中的疗效的临床试验报道了好坏参半的结果。在这项系统的回顾和荟萃分析中，我们评估了他汀类药物在PAH患者中的疗效。我们纳入了随机对照临床试验（RCT），以评估他汀类药物在PAH患者中的疗效。主要结局是死亡率和6分钟步行距离（6MWD）的变化。数据分别以二进制和连续变量的优势比（OR）和加权平均差（WMD）表示，具有95％的置信区间（CIs）。我们包括了4个高质量的RCT。参与者的平均年龄为42±13岁，其中70％为女性。他汀类药物在两项试验中分别为辛伐他汀40–80 mg，在一项试验中为阿托伐他汀10 mg，在另一项试验中为瑞舒伐他汀10 mg。在汇总数据分析中，死亡率（OR：0.75 [95％CI：0.32-1.74]），6MWD（WMD：？9.27 [95％CI：？27.73至9.20]）或心脏疾病无统计学意义的改善与安慰剂相比，他汀类药物治疗的平均指数（WMD：0.11 [95％CI：？0.04至0.27]）。他汀类药物和安慰剂组之间的不良事件差异没有导致停止治疗。这些数据表明他汀类药物在治疗PAH中无益。需要进行大型，进行良好的临床试验，以评估他汀类药物在PAH患者中的作用。未来的试验应包括同质的患者人群，并且应是长期的，事件驱动的，合并发病率和死亡率终点的试验。

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