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首页> 外文期刊>The American Journal of Cardiology >Meta-analysis of the Relation of Body Mass Index to Cardiovascular Outcomes in Patients Receiving Intensive Low-Density Lipoprotein Cholesterol Lowering Therapy
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Meta-analysis of the Relation of Body Mass Index to Cardiovascular Outcomes in Patients Receiving Intensive Low-Density Lipoprotein Cholesterol Lowering Therapy

机译：荟萃分析对接受密集低密度脂蛋白胆固醇降低治疗的患者体重指数对心血管结果的关系

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The impact of body mass index (BMI) on cardiovascular outcomes in patients receiving intensive low-density lipoprotein cholesterol (LDL-C) lowering therapy is uncertain. We performed meta-analysis of 29 randomized controlled trials using PubMed, Embase, and CENTRAL through April 2019. Therapies were grouped as more intensive LDL-C lowering therapy (statins, ezetimibe + statin or PCSK9 inhibitors) and less intensive LDL-C lowering therapy (less potent active control or placebo). Random effects meta-regressions and meta-analyses were performed to evaluate association of BMI with cardiovascular endpoints. In 265,766 patients, for every 1 kg/m(2) increase in BMI, more intensive therapy compared with less intensive therapy was associated with hazard ratio (HR) of 1.07 for cardiovascular mortality (95% confidence interval 1.02 to 1.13); HR of 1.03 for all-cause mortality (0.99 to 1.06) HR of 1.06 for myocardial infarction (1.02 to 1.09), HR of 1.08 (1.03 to 1.12) for revascularization and HR of 1.04 for MACE (1.01 to 1.07). Meta-analysis showed that patients with BMI = 30 kg/m(2) (p-interaction <= 0.05). In conclusion, patients with normal BMI treated with intensive LDL-C lowering regimens may derive a larger clinical benefit compared with patients with larger BMI. The results could be due to the higher mortality rate of obese patients that may artificially lower the efficacy of therapy, or due to a true therapeutic limitation in these patients. (C) 2019 Elsevier Inc. All rights reserved.
机译：体重指数（BMI）对接受密集低密度脂蛋白胆固醇（LDL-C）降低治疗的患者心血管结果的影响是不确定的。我们对2019年4月的PubMed，Embase和Central进行了29种随机对照试验的Meta分析。疗法被分组为更密集的LDL-C降低治疗（他汀类药物，ezetimibe +他汀类药物或PCSK9抑制剂）和更强烈的LDL-C降低治疗（不太有效的主动控制或安慰剂）。进行随机效应元回归和荟萃分析，以评估BMI与心血管终点的关联。在265,766名患者中，BMI每1公斤增加（2）增加BMI，与较小的疗法相比，与危险比（HR）的危险比为1.07的危险比（95％置信区间1.02至1.13）相关;对于所有原因死亡率（0.99至1.06）的HR为1.03的心肌梗死（1.02至1.09），HR为1.08（1.03至1.12），血运重建和支柱的1.04的HR（1.01至1.07）。 Meta分析显示BMI = 30kg / m（2）的患者（p互动<= 0.05）。总之，与较大BMI患者相比，用密集的LDL-C降低方案治疗的正常BMI患者可能导出更大的临床效果。结果可能是由于肥胖患者的死亡率较高，可能会人为地降低治疗的疗效，或由于这些患者的真正治疗局限性。 （c）2019 Elsevier Inc.保留所有权利。

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