The relation of postmenopausal hormone therapy to serum uric acid and the risk of coronary heart disease events: The Heart and Estrogen-Progestin Replacement Study (HERS)
The relation of postmenopausal hormone therapy to serum uric acid and the risk of coronary heart disease events: The Heart and Estrogen-Progestin Replacement Study (HERS)
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DOI：
10.1016/j.annepidem.2005.04.003
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发表时间：
2006-02-01
影响因子：
5.6
通讯作者：
Bittner, V
中科院分区：
文献类型：
--
作者：
Simon, JA;Lin, F;Bittner, V
目得：目的：探讨绝经后女性冠心病患者血清尿酸（UA）水平和雌激素-孕激素（E + P）相关变化是否与冠心病（CHD）事件的复发有关。方法：2763例绝经后女性参加了心脏和雌激素-孕激素替代研究（HERS），随机分为服用结合型E + P或安慰剂组。这些分析的主要结果是平均随访4.1年期间的非致命性心肌梗死或CHD死亡。结果：队列的基线血清UA为5.4 mg/dl，与安慰剂相比，E + P平均在随访1年时血清UA水平略有降低（0.2 mg/dl）（p < 0.0001）。在简单比例风险模型中，基线血清UA水平与CHD事件相关;每增加一个标准差（1.3 mg/dl），原发性CHD事件的风险增加22%（p = 0.0001）。然而，在多变量调整后，这种关联不再具有统计学显著性（p = 0.36）。研究期间血清UA水平的变化与任何CHD outcome.CONCLUSION之间无相关性：E + P治疗可轻微降低血清UA水平，但基线UA和UA收费均不影响CHD风险。
PURPOSE: To determine whether baseline serum uric acid (UA) levels and estrogen-progestin (E + P)associated change in serum UA in postmenopausal women with coronary disease are associated with recurrent coronary heart disease (CHD) events.METHODS: 2763 postmenopausal women enrolled in the Heart and Estrogen-Progestin Replacement Study (HERS) were randomly assigned to take conjugated E + P or placebo in a secondary CHD prevention study. The primary outcome for these analyses was nonfatal myocardial infarction or CHD death during a mean follow up of 4.1 years.RESULTS: The baseline serum UA for the cohort was 5.4 mg/dl and, compared with placebo, E + P on average lowered serum UA levels slightly (0.2 mg/dl) at one year of follow up (p < 0.0001). Baseline serum UA levels were associated in simple proportional hazards models with CHD events; each standard deviation increase (1.3 mg/dl) was associated with a 22% increased risk of primary CHD events (p =.0001). This association, however, was no longer statistically significant after multivariable adjustment (p = 0.36). There was no association between on-study change in serum UA level and any CHD outcome.CONCLUSION: Treatment with E + P lowered serum UA levels slightly, but neither baseline UA nor charge in UA affected CHD risk.