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首页> 外文期刊>Ophthalmology >Statin use and the incidence of advanced age-related macular degeneration in the Complications of Age-related Macular Degeneration Prevention Trial.
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Statin use and the incidence of advanced age-related macular degeneration in the Complications of Age-related Macular Degeneration Prevention Trial.

机译：在年龄相关性黄斑变性预防试验的并发症中使用他汀类药物和晚期年龄相关性黄斑变性的发生率。

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OBJECTIVE: To evaluate the impact of statin use on the incidence of advanced age-related macular degeneration (AMD) and its components, choroidal neovascularization (CNV) and geographic atrophy (GA), among patients with bilateral large drusen. DESIGN: Cohort study within a multicenter, randomized, clinical trial. PARTICIPANTS: Patients enrolled in the Complications of Age-related Macular Degeneration Prevention Trial (CAPT). METHODS: Eligibility criteria for the clinical trial required that participants have >or=10 large (>125 microm) drusen and visual acuity >or=20/40 in each eye. Patients scheduled for their final CAPT visit after May 2005 were interviewed on their history of use of cholesterol-lowering medications, including statins. Trained readers identified CNV and end point GA (>1 Macular Photocoagulation Study disc area of GA) based on review of fluorescein angiograms and fundus photographs taken at annual follow-up visits and when patients reported symptoms. The risk ratio for participants developing CNV or developing GA associated with statin use was estimated with time-dependent Cox proportional hazards models. MAIN OUTCOME MEASURES: Development of advanced AMD, CNV, and end point GA. RESULTS: Among 764 patients eligible for the interview, 744 (97.4%) patients completed the interview on medication use. Statin use was reported by 296 (39.8%) of those interviewed, with the majority, 187 (63.2%) of the 296, beginning use after enrollment in CAPT. Among 744 patients, advanced AMD developed in 332 (22.5%) eyes of 242 (32.5%) patients, CNV in 222 (15%) eyes of 176 (23.7%) patients, and GA in 114 (7.7%) eyes of 80 (10.8%) patients. With adjustment for other risk factors, the estimated risk ratio for eyes (95% confidence interval) associated with statin use was 1.15 (0.87-1.52) for advanced AMD, 1.35 (0.99-1.83) for CNV, and 0.80 (0.46-1.39) for GA. CONCLUSIONS: The CAPT data are not consistent with a strong protective effect (risk ratio,
机译：目的：评估他汀类药物对双侧大玻璃膜疣患者晚期老年性黄斑变性（AMD）及其组分，脉络膜新生血管（CNV）和地理萎缩（GA）发生率的影响。设计：在多中心随机临床试验中进行队列研究。研究对象：年龄相关性黄斑变性预防试验（CAPT）并发症的患者。方法：临床试验的入选标准要求参与者每只眼睛的玻璃疣大于或等于10个（> 125微米），视力大于或等于20/40。计划在2005年5月之后进行最后一次CAPT访视的患者接受了降胆固醇药物（包括他汀类药物）使用史的采访。受过训练的读者可根据对荧光素血管造影照片和在每年一次随访中以及患者报告症状时所拍摄的眼底照片的回顾来确定CNV和终点GA（GA大于1的黄斑光凝研究盘区域）。用与时间有关的Cox比例风险模型估算了与使用他汀类药物相关的CNV或GA参与者的风险比。主要观察指标：开发先进的AMD，CNV和终点GA。结果：在764名符合资格的患者中，有744名（97.4％）患者完成了药物使用的访谈。据报道，有296名受访者（39.8％）使用了他汀类药物，而在296名参加CAPT后就开始使用，其中大多数为296名（187名）（63.2％）。在744例患者中，有242例（32.5％）的332眼（22.5％）发生了晚期AMD，在176例（23.7％）的222眼中有CNV（15％），在80例的114眼（7.7％）中出现了GA（ 10.8％）的患者。调整其他风险因素后，与他汀类药物使用相关的双眼估计风险比（95％置信区间）是晚期AMD为1.15（0.87-1.52），CNV为1.35（0.99-1.83）和0.80（0.46-1.39）对于GA。结论：CAPT数据与他汀类药物对双侧大玻璃疣患者晚期AMD发生发展的强保护作用（风险比，<或= 0.85）不一致。

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