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首页> 外文期刊>Circulation journal >Comparison of preventive effect on cardiovascular events with different statins. -The CIRCLE study-.
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Comparison of preventive effect on cardiovascular events with different statins. -The CIRCLE study-.

机译：比较不同他汀类药物对心血管事件的预防作用。 -循环学习-。

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BACKGROUND: Although statins vary in their effectiveness in lowering low-density lipoprotein cholesterol (LDL-C) and increasing high-density lipoprotein cholesterol (HDL-C) levels, there is little evidence that the degree of these changes can explain cardiac risk reduction in Japan. Our objective was to compare the efficacy of statins on serum lipid levels and to explore the association between those changes and cardiac events in patients after percutaneous coronary intervention (PCI). METHODS AND RESULTS: The 743 consecutive patients who underwent PCI from 2001 to 2008 were retrospectively investigated. Treatment with either atorvastatin or pitavastatin significantly reduced LDL-C compared with pravastatin or no statin. In contrast, only pitavastatin treatment significantly increased HDL-C (13.4 +/- 22.9%, P=0.01 vs. no statin). Each statin significantly prevented major adverse cardiac events (MACE) compared with no statin, and pitavastatin was the most effective of all. Multivariate-adjusted analysis revealed that percent changes of both LDL-C and HDL-C independently predicted the incidence of MACE (hazard ratio [HR]: 1.015; 95% confidence interval [CI]: 1.010-1.020, HR: 0.988; 95%CI: 0.981-0.996, respectively). This relationship was preserved in patients with a baseline HDL-C level 45 mg/ml. CONCLUSIONS: The extent of changes in LDL-C and HDL-C with statin treatment would independently alter the risk of cardiac events in Japanese patients for secondary prevention. Statins with varying lipid-modifying ability might provide differing prognosis in patients after PCI.
机译：背景：尽管他汀类药物在降低低密度脂蛋白胆固醇（LDL-C）和增加高密度脂蛋白胆固醇（HDL-C）水平方面的效果各不相同，但很少有证据表明这些变化的程度可以解释降低心脏风险的原因。日本。我们的目的是比较他汀类药物对血脂水平的疗效，并探讨经皮冠状动脉介入治疗（PCI）后患者这些变化与心脏事件之间的关系。方法和结果：回顾性分析2001年至2008年间743例行PCI的患者。与普伐他汀或无他汀类药物相比，用阿托伐他汀或匹伐他汀治疗可显着降低LDL-C。相反，仅匹伐他汀治疗可显着增加HDL-C（13.4 +/- 22.9％，P = 0.01 vs.他汀类药物）。与没有他汀类药物相比，每种他汀类药物均能显着预防重大不良心脏事件（MACE），而匹伐他汀是最有效的。多元调整分析显示，LDL-C和HDL-C的变化百分比独立预测了MACE的发生率（危险比[HR]：1.015; 95％置信区间[CI]：1.010-1.020，HR：0.988; 95％ CI：分别为0.981-0.996）。基线HDL-C水平 45 mg / ml的患者中，这种关系得以保留。结论：他汀类药物治疗对LDL-C和HDL-C的改变程度将独立改变日本患者二级预防心脏事件的风险。他汀类药物具有不同的脂质修饰能力，可能在PCI后为患者提供不同的预后。

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