Potential nontraditional applications of statins
Potential nontraditional applications of statins
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DOI：
10.1345/aph.1c499
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发表时间：
2003-07-01
影响因子：
2.9
通讯作者：
McKenney, JM
中科院分区：
文献类型：
--
作者：
McKenney, JM
目的：回顾羟甲基戊二酰辅酶A还原酶抑制剂（他汀类药物）在非传统脂质相关应用（包括急性冠状动脉综合征、外周动脉疾病、中风和肾脏疾病）中的应用的现有证据，并描述正在进行的评估他汀类药物在这些疾病中作用的试验。通过MEDLINE检索识别临床文献（1990- 2002年11月），使用以下检索词之一：急性冠状动脉综合征、心绞痛、动脉粥样硬化、阿托伐他汀、临床试验、糖尿病、终末期肾病、氟伐他汀、洛伐他汀，心肌梗死、外周动脉疾病、普伐他汀、辛伐他汀、他汀类药物和中风。对美国糖尿病协会、美国心脏协会、国家胆固醇教育计划、国家肾脏基金会和国家中风基金会等专业和政府组织发布的治疗指南进行了回顾。如果从数据源中识别出的文章与目标中描述的情况有关，并提供了关于使用他汀类药物：资料综合：大量证据表明他汀类药物用于急性冠状动脉综合征。对主要临床试验数据的荟萃分析表明，他汀类药物可预防首次和复发性卒中，目前正在进行大规模试验以评估他汀类药物在这种情况下的疗效。越来越多的证据表明，他汀类药物可能有助于降低外周动脉疾病和终末期肾病相关的发病率和死亡率，正在进行的试验结果可能证实这些益处。他汀类药物也可能有一个未来的作用，在改善其他条件与动脉粥样硬化，如diabetesmellitus.CONCLUSIONS：大量的证据支持他汀类药物在临床环境中的评价超出初级和二级预防冠状动脉粥样硬化相关的发病率和死亡率。
OBJECTIVE: To review the current evidence for use of hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) in nontraditional lipid-related applications, including acute coronary syndromes, peripheral arterial disease, stroke, and renal disease, and to describe ongoing trials evaluating the role of statins in these conditions.DATA SOURCES: Clinical literature was identified by a MEDLINE search (1990-November 2002) using 1 of the following search terms: acute coronary syndrome(s), angina pectoris, atherosclerosis, atorvastatin, clinical trials, diabetes mellitus, end-stage renal disease, fluvastatin, lovastatin, myocardial infarction, peripheral arterial disease, pravastatin, simvastatin, statins, and stroke. Treatment guidelines issued by professional and governmental organizations, such as the American Diabetes Association, American Heart Association, National Cholesterol Education Program, National Kidney Foundation, and National Stroke Foundation, were reviewed.STUDY SELECTION AND DATA EXTRACTION: Articles identified from the data sources were included if they pertained to the conditions described in the objectives and provided unique information concerning use of statins.DATA SYNTHESIS: Substantial evidence exists for the use of statins in acute coronary syndromes. Meta-analyses of data from major clinical trials indicate that statins prevent first and recurrent stroke, and large-scale trials are underway to evaluate the efficacy of statins in this setting. Accumulating evidence suggests that statins may be beneficial in reducing the morbidity and mortality associated with peripheral arterial disease and end-stage renal disease, and results from ongoing trials may confirm these benefits. Statins may also have a future role in amelioration of other conditions associated with atherosclerosis, such as diabetes mellitus.CONCLUSIONS: A large body of evidence supports the evaluation of statins in clinical settings beyond primary and secondary prevention of morbidity and mortality associated with coronary atherosclerosis.