New England Journal of Medicine· 2015Q1· Klinik çalışma
Akut Koroner Sendromlar Sonrası Statin Tedavisine Ezetimibin Eklenmesi
Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes
- 4.433atıf
- Q1SCImago
- 2015yıl
Kısa özet
Akut koroner sendrom nedeniyle hastaneye yatırılan hastalarda, statin tedavisine ezetimib eklenmesi, 6 yıllık ortalama takip süresince statin monoterapisine kıyasla kardiyovasküler olayları %7 oranında daha da azaltmıştır.
Yapay zekâ ile başlık ve abstract'tan üretildi; tam metin okunmaz.
Ana noktalar
- Simvastatine ezetimib eklenmesi, ortalama LDL kolesterol düzeyini 69.5 mg/dL'den 53.7 mg/dL'ye düşürmüştür.
- Simvastatin-ezetimib grubunda 7 yıl boyunca majör kardiyovasküler olay (ölüm, kalp krizi, felç) oranında %7 daha düşük bir oran gözlenmiştir.
- Birincil son nokta için mutlak risk azalması 2.0 yüzde puanı olmuştur.
- Kas, safra kesesi ve karaciğer sorunları ile kanser gibi önceden belirlenmiş yan etki oranları iki grupta benzerdi.
Yapay zekâ ile başlık ve abstract'tan üretildi; tam metin okunmaz.
Özet (abstract)
BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardiovascular events further is not known. METHODS: We conducted a double-blind, randomized trial involving 18,144 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 days and had LDL cholesterol levels of 50 to 100 mg per deciliter (1.3 to 2.6 mmol per liter) if they were receiving lipid-lowering therapy or 50 to 125 mg per deciliter (1.3 to 3.2 mmol per liter) if they were not receiving lipid-lowering therapy. The combination of simvastatin (40 mg) and ezetimibe (10 mg) (simvastatin-ezetimibe) was compared with simvastatin (40 mg) and placebo (simvastatin monotherapy). The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization (≥30 days after randomization), or nonfatal stroke. The median follow-up was 6 years. RESULTS: The median time-weighted average LDL cholesterol level during the study was 53.7 mg per deciliter (1.4 mmol per liter) in the simvastatin-ezetimibe group, as compared with 69.5 mg per deciliter (1.8 mmol per liter) in the simvastatin-monotherapy group (P<0.001). The Kaplan-Meier event rate for the primary end point at 7 years was 32.7% in the simvastatin-ezetimibe group, as compared with 34.7% in the simvastatin-monotherapy group (absolute risk difference, 2.0 percentage points; hazard ratio, 0.936; 95% confidence interval, 0.89 to 0.99; P=0.016). Rates of prespecified muscle, gallbladder, and hepatic adverse effects and cancer were similar in the two groups. CONCLUSIONS: When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes. Moreover, lowering LDL cholesterol to levels below previous targets provided additional benefit. (Funded by Merck; IMPROVE-IT ClinicalTrials.gov number, NCT00202878.).
Yazarların özeti; kaynağından alınmıştır. New England Journal of Medicine, 2015 · DOI ↗
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