Cardiovascular effects of raloxifene: The arterial and venous systems
Cardiovascular effects of raloxifene: The arterial and venous systems
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DOI：
10.1016/j.ahj.2003.12.019
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发表时间：
2004-05-01
影响因子：
4.8
通讯作者：
Dowsett, SA
中科院分区：
文献类型：
--
作者：
Blumenthal, RS;Baranowski, B;Dowsett, SA
背景由动脉粥样硬化引起的心血管疾病是女性最大的单一杀手。先前的观察数据表明激素治疗可能具有心脏保护作用。方法对临床试验和基础科学研究的数据进行评估，以评估激素治疗和选择性雌激素替代调节剂对心血管的影响。结果激素治疗似乎并不能降低老年绝经后女性心血管事件的风险。选择性雌激素受体调节剂（SERMS）已被批准用于人类；他莫昔芬用于治疗和预防乳腺癌，雷洛昔芬用于治疗和预防骨质疏松症。雷洛昔芬是唯一一种在前瞻性、随机、对照试验中专门研究其对冠心病事件影响的 SERM。 结论 虽然雷洛昔芬确实会增加静脉血栓栓塞事件，但有提示性数据表明它可能对女性动脉系统产生有利影响。只有来自雷洛昔芬用于心脏 (RUTH) 试验的令人信服的积极数据才会导致更多地使用 SERMS，从而有可能降低动脉粥样硬化性血管疾病的风险。
Background Cardiovascular disease caused by atherosclerosis is the largest single killer of women. Prior observational data had suggested that hormone therapy may have cardioprotective effects.Methods Data from clinical trials and basic science studies were evaluated to assess the cardiovascular effects of hormone therapy and selective estrogen replacement modulators.Results Hormone therapy does not appear to lower the risk of cardiovascular events in older postmenopausal women. Selective estrogen receptor modulators (SERMS) have been approved for human use; tamoxifen is used for treatment and prevention of breast cancer and raloxifene is used for the treatment and prevention of osteoporosis. Raloxifene is the only SERM being specifically studied for its effects on coronary heart disease events in a prospective, randomized, controlled trial.Conclusions Although raloxifene does increase venous thromboembolic events, there is suggestive data that it may have favorable effects on the arterial systems in women. Only compelling positive data from the Raloxifene Use for The Heart (RUTH) trial will lead to greater use of SERMS to potentially lower the risk of atherosclerotic vascular disease.