Bezafibrate for the secondary prevention of myocardial infarction in patients with metabolic syndrome
Bezafibrate for the secondary prevention of myocardial infarction in patients with metabolic syndrome
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DOI：
10.1001/archinte.165.10.1154
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发表时间：
2005-05-23
影响因子：
--
通讯作者：
Behar, S
中科院分区：
文献类型：
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作者：
Tenenbaum, A;Motro, M;Behar, S
背景：代谢综合征（MS）和心肌梗死（MI）之间存在一致的关系已被证明。我们评估了苯扎贝特缓释剂（一种纤维酸衍生物）对参加苯扎贝特梗塞预防 (BIP) 研究的 MS 患者的 MI 发生率的影响。 方法：表现出以下 5 种危险因素中至少 3 种的患者被认为患有 MS：（1）空腹血糖水平 110 mg/dL（6.11 mmol/L）； (2) 甘油三酯水平为 150 mg/dL (1.70 mmol/L)； (3) 男性高密度脂蛋白胆固醇水平低于 40 mg/dL (< 1.04 mmol/L)，女性低于 50 mg/dL (< 1.30 mmol/L)； (4)收缩压130毫米汞柱或舒张压85毫米汞柱； (5) 体重指数为 28.0 kg/m(2)。此次事后亚组分析的研究样本包括 1470 名年龄在 42 岁至 74 岁之间的患者。患者每天一次接受 400 毫克苯扎贝特缓释剂（740 名患者）或安慰剂（730 名患者）。事件的平均随访时间为 6.2 年，死亡率数据的平均随访时间为 8.1 年。 结果：193 名患者记录了新发 MI：苯扎贝特组 740 名患者中有 82 名患者 (11.1%)，而安慰剂组 730 名患者中有 111 名患者 (15.2%) (P=.02)。苯扎贝特可降低任何 MI 和非致命性 MI 的风险，其风险比 (HR) 分别为 0.71（95% 置信区间 [CI]，0.54-0.95）和 0.67（95% CI，0.49-0.91）。服用苯扎贝特的患者心脏死亡风险往往较低（FIR，0.74；95% CI，0.54-1.03）。在 575 名具有 MS 增强特征（4-5 个危险因素）的患者中，服用苯扎贝特可显着降低心脏死亡率（HR，0.44；95% CI，0.25-0.80）。结论：长期随访期间，苯扎贝特可降低 MS 患者的 MI 发生率。
Background: A consistent relationship between metabolic syndrome (MS) and myocardial infarction (MI) has been demonstrated. We evaluated the effect of bezafibrate retard, a fibric acid derivative, on the incidence of MI in patients with MS enrolled in the Bezafibrate Infarction Prevention (BIP) study.Methods: Patients who displayed at least 3 of the following 5 risk factors were considered to have MS: (1) a fasting glucose level of 110 mg/dL (6.11 mmol/L); (2) a triglyceride level of 150 mg/dL (1.70 mmol/L); (3) a high-density lipoprotein cholesterol level less than 40 mg/dL (< 1.04 mmol/L) in men or less than 50 mg/dL (< 1.30 mmol/L) in women; (4) a systolic blood pressure of 130 mm Hg or diastolic blood pressure of 85 mm Hg; and (5) a body mass index of 28.0 kg/m(2). The study sample for this post hoc subgroup analyses comprised 1470 patients aged 42 to 74 years. The patients received either 400 ing of bezafibrate retard (740 patients) or placebo (730 patients) once a day. The mean follow-up period was 6.2 years for events and 8.1 years for mortality data.Results: New MI was recorded in 193 patients: 82 (11.1%) of the 740 patients in the bezafibrate group vs 111 (15.2%) of the 730 patients in the placebo group (P=.02). Bezafibrate was associated with a reduced risk of any MI and nonfatal MI with hazard ratios (HRs) of 0.71 (95% confidence interval [CI], 0.54-0.95) and 0.67 (95% CI, 0.49-0.91), respectively. The cardiac mortality risk tended to be lower in patients taking bezafibrate (FIR, 0.74; 95% CI, 0.54-1.03). In 575 patients with augmented features of MS (4-5 risk factors), the remarkable strengthening of cardiac mortality reduction when taking bezafibrate (HR, 0.44; 95% CI, 0.25-0.80) should be noted.Conclusion: Bezafibrate reduces the incidence of MI in patients with MS during long-term follow-up.