BACKGROUND: Recent trials have demonstrated better outcomes with intensive than with moderate statin treatment. Intensive treatment produced greater reductions in both low-density lipoprotein(LDL)cholesterol and C-rea...BACKGROUND: Recent trials have demonstrated better outcomes with intensive than with moderate statin treatment. Intensive treatment produced greater reductions in both low-density lipoprotein(LDL)cholesterol and C-reactive protein(CRP), suggesting a relationship between these two biomarkers and disease progression. METHODS: We performed intravascular ultrasonography in 502 patients with angiographically documented coronary disease. Patients were randomly assigned to receive moderate treatment(40 mg of pravastatin orally per day)-or intensive treatment(80 mg of atorvastatin orally per day). Ultrasonography was repeated after 18 months to measure the progression of atherosclerosis. Lipoprotein and CRP levels were measured at baseline and followup. RESULTS: In the group as a whole, the mean LDL cholesterol level was reduced from 150.2 mg per deciliter(3.88 mmol per liter)at baseline to 94.5 mg per deciliter(2.44 mmol per liter)at 18 months(P< 0.001), and the geometric mean CRP level decreased from 2.9 to 2.3 mg per liter(P< 0.001). The correlation between the reduction in LDL cholesterol levels and that in CRP levels was weak but significant in the group as a whole(r=0.13, P=0.005), but not in either treatment group alone. In univariate analyses, the percent change in the levels of LDL cholesterol, CRP, apolipoprotein B-100, and nonhigh-density lipoprotein cholesterol were related to the rate of progression of atherosclerosis. After adjustment for the reduction in these lipid levels, the decrease in CRP levels was independently and significantly correlated with the rate of progression. Patients with reductions in both LDL cholesterol and CRP that were greater than the median had significantly slower rates of progression than patients with reductions in both biomarkers that were less than the median(P=0.001). CONCLUSIONS: For patients with coronary artery disease, the reduced rate of progression of atherosclerosis associated with intensive statin treatment, as compared with moderate statin treatment, is significantly related to greater reductions in the levels of both atherogenic lipoproteins and CRP.展开更多
降脂治疗预防静脉血栓栓塞的荟萃分析他汀类药物可降低静脉血栓栓塞(VTE)的风险,为比较不同降脂方案在VTE一级预防中的效果,欧洲学者对PubMed、CEN-TRAL和Web of Science进行系统文献检索(截止时间为2022年11月2日),筛选出他汀类药物(...降脂治疗预防静脉血栓栓塞的荟萃分析他汀类药物可降低静脉血栓栓塞(VTE)的风险,为比较不同降脂方案在VTE一级预防中的效果,欧洲学者对PubMed、CEN-TRAL和Web of Science进行系统文献检索(截止时间为2022年11月2日),筛选出他汀类药物(高或低/中等强度)、依折麦布或前蛋白转化酶枯草溶菌素9抑制剂(PCSK9i)的随机对照试验(RCT),并进行荟萃分析。研究纳入45项RCT(254933例患者),共报告了2084例VTE事件。展开更多
文摘BACKGROUND: Recent trials have demonstrated better outcomes with intensive than with moderate statin treatment. Intensive treatment produced greater reductions in both low-density lipoprotein(LDL)cholesterol and C-reactive protein(CRP), suggesting a relationship between these two biomarkers and disease progression. METHODS: We performed intravascular ultrasonography in 502 patients with angiographically documented coronary disease. Patients were randomly assigned to receive moderate treatment(40 mg of pravastatin orally per day)-or intensive treatment(80 mg of atorvastatin orally per day). Ultrasonography was repeated after 18 months to measure the progression of atherosclerosis. Lipoprotein and CRP levels were measured at baseline and followup. RESULTS: In the group as a whole, the mean LDL cholesterol level was reduced from 150.2 mg per deciliter(3.88 mmol per liter)at baseline to 94.5 mg per deciliter(2.44 mmol per liter)at 18 months(P< 0.001), and the geometric mean CRP level decreased from 2.9 to 2.3 mg per liter(P< 0.001). The correlation between the reduction in LDL cholesterol levels and that in CRP levels was weak but significant in the group as a whole(r=0.13, P=0.005), but not in either treatment group alone. In univariate analyses, the percent change in the levels of LDL cholesterol, CRP, apolipoprotein B-100, and nonhigh-density lipoprotein cholesterol were related to the rate of progression of atherosclerosis. After adjustment for the reduction in these lipid levels, the decrease in CRP levels was independently and significantly correlated with the rate of progression. Patients with reductions in both LDL cholesterol and CRP that were greater than the median had significantly slower rates of progression than patients with reductions in both biomarkers that were less than the median(P=0.001). CONCLUSIONS: For patients with coronary artery disease, the reduced rate of progression of atherosclerosis associated with intensive statin treatment, as compared with moderate statin treatment, is significantly related to greater reductions in the levels of both atherogenic lipoproteins and CRP.
文摘降脂治疗预防静脉血栓栓塞的荟萃分析他汀类药物可降低静脉血栓栓塞(VTE)的风险,为比较不同降脂方案在VTE一级预防中的效果,欧洲学者对PubMed、CEN-TRAL和Web of Science进行系统文献检索(截止时间为2022年11月2日),筛选出他汀类药物(高或低/中等强度)、依折麦布或前蛋白转化酶枯草溶菌素9抑制剂(PCSK9i)的随机对照试验(RCT),并进行荟萃分析。研究纳入45项RCT(254933例患者),共报告了2084例VTE事件。
