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首页> 外文期刊>Current opinion in lipidology >Fenofibrate therapy and cardiovascular protection in diabetes: recommendations after FIELD.
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Fenofibrate therapy and cardiovascular protection in diabetes: recommendations after FIELD.

机译:非诺贝特治疗和糖尿病的心血管保护:FIELD之后的建议。

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PURPOSE OF REVIEW: The aim of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study was to provide valuable information on the ability of fibrates to reduce cardiovascular risk in type 2 diabetes. The purpose of this review is to analyse results from FIELD and to see whether they may lead to modify the recommendations for treatment of diabetic dyslipidemia. RECENT FINDINGS: In FIELD, fenofibrate therapy was associated with a nonsignificant 11% reduction in the primary endpoint (coronary heart disease death, nonfatal myocardial infarction), corresponding to a significant 24% reduction in nonfatal myocardial infarction (P = 0.010) and a nonsignificant 19% increase in CHD mortality. Fenofibrate reduced CHD events only in patients in primary prevention, but not in secondary prevention. Fenofibrate treatment was associated with less albuminuria progression and less retinopathy needing laser treatment. SUMMARY: FIELD's results are somewhat disappointing. The relatively low cardiovascular risk population from FIELD and the 'pollution' by statin therapy may not totally explain the weak results of fenofibrate in the reduction in CHD events. The significant increase in plasma homocysteine observed with fenofibrate could partly explain not only the higher number of venous thrombotic events, but also the poor effect of fenofibrate in reducing clinical outcomes, more particularly in patients with previous cardiovascular disease.
机译:审查目的:非诺贝特干预和降低糖尿病事件(FIELD)研究的目的是提供有关贝特类降低2型糖尿病心血管风险的能力的有价值的信息。这篇综述的目的是分析FIELD的结果,看看它们是否可能导致修改糖尿病血脂异常的治疗建议。最近的发现:在现场,非诺贝特治疗与主要终点(冠心病死亡,非致命性心肌梗死)无显着性降低11%相关,与非致命性心肌梗死显着降低24%(P = 0.010)和无显着性相关冠心病死亡率增加19%。非诺贝特仅在一级预防中降低了冠心病事件,而在二级预防中未降低。非诺贝特治疗与较少的蛋白尿进展和较少的需要激光治疗的视网膜病变相关。简介:FIELD的结果有些令人失望。来自FIELD的相对较低的心血管风险人群和他汀类药物疗法的“污染”可能无法完全解释非诺贝特在冠心病事件减少中的不良结果。用非诺贝特观察到的血浆同型半胱氨酸的显着增加不仅可以部分解释静脉血栓事件的增多,还可以解释非诺贝特在降低临床结局方面的不良作用,尤其是在患有心血管疾病的患者中。

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