Effectiveness of antihyperlipidemic drug management in clinical practice
Effectiveness of antihyperlipidemic drug management in clinical practice
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DOI：
10.1016/s0149-2918(00)86743-0
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发表时间：
1999-11-01
影响因子：
3.2
通讯作者：
Platt, R
中科院分区：
文献类型：
--
作者：
Andrade, SE;Saperia, GM;Platt, R
尽管随机临床试验已经令人信服地显示了抗高脂血药的疗效，但停用抗高脂血药和未能达到目标血脂水平都可能减弱这些药物在降低冠状动脉事件住院率方面的作用。本研究比较了住院率和低密度脂蛋白胆固醇（LDL-C）水平在抗高脂血症药物治疗期间和停止后。本文采用回顾性队列研究方法，对1988 ~ 1994年在2家健康维护机构（HMOs）就诊的2369例患者进行研究。在开始或停止药物治疗后14至180天内，比较使用和未使用抗高脂血症药物期间的冠心病相关住院率和非冠心病相关住院率以及LDL-C水平。抗高脂血症药物使用期间冠心病住院率与未使用期间的比率为1.02 (95% CI, 0.74 - 1.40)，不包括开始或停药后的前6个月，并控制患者的性别、年龄、冠心病史、高血压、糖尿病和HMO地点。相比之下，非冠心病住院的校正率比为0.70 （95% CI, 0.61 ~ 0.80）。有冠心病史的患者达到LDL-C水平的百分比
Although randomized clinical trials have convincingly shown the efficacy of antihyperlipidemic drugs, both discontinuation of antihyperlipidemic drugs and failure to achieve goal lipid levels would be expected to attenuate the effect of these drugs on reducing the rates of hospitalization for coronary events. This study compares the rates of hospitalization and low-density lipoprotein cholesterol (LDL-C) levels during and after discontinuation of antihyperlipidemic drug therapy. A retrospective cohort study was conducted among 2369 patients at 2 health maintenance organizations (HMOs) during the period 1988 to 1994. Rates of coronary heart disease (CHD)-related hospitalization and non-CHD-related hospitalization and the LDL-C levels between 14 and 180days after the initiation or discontinuation of drug therapy were compared for periods of antihyperlipidemic drug use and nonuse. The rate ratio for CHD hospitalization during periods of antihyperlipidemic drug use compared with periods of nonuse was 1.02 (95% CI, 0.74 to 1.40), excluding the first 6 months after initiation or discontinuation and controlling for patient sex, age, history of CHD, hyper tension, diabetes, and HMO site. By contrast, the adjusted rate ratio was 0.70 (95% CI, 0.61 to 0.80) for non-CHD hospitalization. The percentage of patients with a history of CHD who achieved LDL-C levels