Effect of statins alone versus statins plus ezetimibe on carotid atherosclerosis in type 2 diabetes: the SANDS (Stop Atherosclerosis in Native Diabetics Study) trial.
Effect of statins alone versus statins plus ezetimibe on carotid atherosclerosis in type 2 diabetes: the SANDS (Stop Atherosclerosis in Native Diabetics Study) trial.
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DOI：
10.1016/j.jacc.2008.10.031
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发表时间：
2008-12-16
影响因子：
24
通讯作者：
Howard, Wm. James
中科院分区：
文献类型：
--
作者：
Fleg, Jerome L.;Mete, Mihriye;Howard, Barabara V.;Umans, Jason G.;Roman, Mary J.;Ratner, Robert E.;Silverman, Angela;Galloway, James M.;Henderson, Jeffrey A.;Weir, Matthew R.;Wilson, Charlton;Stylianou, Mario;Howard, Wm. James
这项来自停止本土糖尿病患者动脉粥样硬化研究的二次分析考察了单独使用他汀类药物降低低密度脂蛋白胆固醇(LDL-C)与他汀类药物加依折麦布(E)对2型糖尿病患者颈总动脉内中膜厚度(CIMT)的影响。目前尚不清楚在他汀类药物治疗的基础上添加E是否会影响亚临床动脉粥样硬化。在积极组中(目标低密度脂蛋白≤70 mg/dL；非高密度脂蛋白-C≤<；100 mg/dL；收缩压≤115毫米汞)，比较了服用他汀类药物加E的糖尿病患者和40年前仅服用他汀类药物的糖尿病患者在36个月以上的CIMT变化。将两个侵袭性亚组的CIMT变化与标准亚组(靶≤-C≤100 mg/dL；非高密度脂蛋白≤130 mg/dL；收缩压130 mm Hg)的变化进行比较。他汀类药物加E组和单用他汀类药物组的平均(95%CI)−-C分别降低31(23，37)mg/dL和32(27，38)mg/dL，而标准组(P<；0.0001)降低1(LDL3，6)mg/dL。在积极组中，E亚组(−.025[−05，0.003]mm)和非E亚组(−.012[−.03，.008]mm)在36个月时的平均IMT较基线有相似的倒退，但在标准治疗组(0.039[0.02，0.06]mm)，组间p<；0.0001有进展。在单用他汀类药物或他汀类药物加E降低低密度脂蛋白胆固醇水平相当的患者中，将低密度脂蛋白降低到积极的目标会导致类似的CIMT退化，而达到标准目标的患者CIMT增加。
This secondary analysis from the Stop Atherosclerosis in Native Diabetics Study examines the effects of lowering low-density lipoprotein cholesterol (LDL-C) with statins alone versus statins plus ezetimibe (E) on common carotid artery intimal medial thickness (CIMT) in patients with type 2 diabetes and no prior cardiovascular event. It is unknown whether the addition of E to statin therapy affects subclinical atherosclerosis. Within an aggressive group (target LDL-C ≤70mg/dL; non-high-density lipoprotein [non-HDL]-C ≤<100 mg/dL; systolic blood pressure [SBP] ≤115mmHg), change in CIMT over 36mos was compared in diabetic individuals >40 yrs receiving statins plus E versus statins alone. CIMT changes in both aggressive subgroups were compared with changes in the standard subgroups (target LDL-C ≤<100mg/dL; non-HDL-C ≤ 130 mg/dL; SBP ≤130mmHg). Mean (95%CI) LDL-C was reduced by 31 (23, 37)mg/dL and 32 (27, 38)mg/dL in the aggressive group receiving statins plus E and statins alone, respectively, compared with changes of 1 (−3, 6) mg/dL in the standard group (p<0.0001 vs both aggressive subgroups. Within the aggressive group, mean IMT at 36mos regressed from baseline similarly in the E (−.025 [−05,.003] mm) and non-E subgroups (−.012 [−.03,.008] mm) but progressed in the standard treatment arm (0.039 [0.02, 0.06] mm), intergroup p<0.0001. Reducing LDL-C to aggressive targets resulted in similar regression of CIMT in patients who attained equivalent LDL-C reductions from a statin alone or statin plus E. CIMT increased in those achieving standard targets.
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影响因子：
4.8
作者：
Russell, Marie;Fleg, Jerome L.;Howard, Barbara V.
通讯作者：
Howard, Barbara V.
影响因子：
37.8
作者：
Bruckert, E;Giral, P;Tellier, P
通讯作者：
Tellier, P
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37.8
作者：
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DEVEREUX, RB
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158.5
作者：
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de Groot, Eric
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158.5
作者：
Rossebo, Anne B.;Pedersen, Terje R.;Willenheimer, Ronnie
通讯作者：
Willenheimer, Ronnie