What do the statin trials tell us?
What do the statin trials tell us?
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他汀类药物试验告诉我们什么？
DOI：
10.1002/clc.4960241502
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发表时间：
2001
影响因子：
2.7
通讯作者：
D. Waters
中科院分区：
文献类型：
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作者：
D. Waters
五项大规模、随机、安慰剂对照试验的结果，涉及近31,000名受试者，证实了他汀类药物在预防冠状动脉事件方面的益处。根据这些调查所得的证据，可以得出若干关键的观察结果。最重要的是，他汀类药物可降低有或无冠心病患者的冠状动脉事件发生率。他汀类药物治疗的风险降低百分比逐年增加。此外，风险的降低与低密度脂蛋白胆固醇的降低成正比。亚组分析表明，他汀类药物的疗效扩展到特定的患者亚组，包括妇女、糖尿病患者和老年人。这些药物还可以降低冠心病患者中风和短暂性脑缺血发作的风险。随机试验和广泛的临床经验都证实他汀类药物是安全的，不会增加患癌症或死亡的风险。他汀类药物可以改善动脉粥样硬化风险的几个标志，尽管这一观察结果的临床意义仍在研究中。他汀类药物广泛的治疗效果在目前的实践中产生了安全、有效的高胆固醇血症治疗，同时也为未来进一步的治疗改进提供了基础。
The results of five large‐scale, randomized, placebo‐controlled trials, involving nearly 31,000 subjects, attest to the benefits of statins in the prevention of coronary events. Several key observations can be made on the basis of the evidence from these investigations. Of primary importance is the fact that statins reduce coronary event rates in patients with or without coronary heart disease. The percentage reduction in risk increases with each successive year of statin therapy. Moreover, the risk reduction is proportional to the reduction in low‐density lipoprotein cholesterol. Subgroup analyses have demonstrated that the efficacy of statins extends to specific subgroups of patients, including women, people with diabetes, and older individuals. These agents also reduce the risk of stroke and transient ischemic attacks in patients with coronary disease. Both the randomized trials and widespread clinical experience have confirmed that statins are safe and do not increase the risk of cancer or mortality. Several markers of atherosclerotic risk are ameliorated by statins, although the clinical significance of this observation remains under investigation. The broad range of the therapeutic effects of statins yields safe, effective management of hypercholesterolemia in current practice while also providing a foundation for additional therapeutic refinements in the future.