【阿托伐他汀治疗重大心血管事件的疗效和安全性:荟萃分析】。

Víctor Eder Villegas-Quintero, Rodolfo Rivas-Ruíz, Alexis Alejandro García-Rivero, Pedro Rivera-Lara, Nelly Berenice González-Tovar
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引用次数: 0

摘要

引言:阿托伐他汀已被用于治疗血脂异常,但对大剂量阿托伐他丁用于重大心血管事件(MACE)二级预防的疗效和安全性知之甚少。目的:评价大剂量阿托伐他汀对MACE及不良事件二级预防的影响。材料和方法:对Pubmed、Embase、Bireme和Cochrane Library Plus数据库进行系统回顾和荟萃分析,时间范围为1990年至2022年7月。纳入了6项随机临床试验,共有29333名患者接受了80 mg、10 mg或安慰剂剂量的阿托伐他汀治疗,评估的主要结果为重大心血管事件(MACE)、死亡率和治疗安全性。结果:在使用80 mg阿托伐他汀与其他疗法的比较研究中,发现相对风险(RR)为0.8(95%CI 0.69-0.92),代表风险(RRR)降低20%,需要治疗的次数(NNT)为30-55。在不良反应分析中,观察到的RR为2.37(95%CI 0.86-6.53),所需伤害数(NNH)为14-19。在较低剂量下,使用80 mg阿托伐他汀与类似的不良事件有关。结论:阿托伐他汀80mg用于重大心血管事件(MACE)的二级预防是有效的。该药物存在不良事件,应在二级预防中予以考虑。
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[Efficacy and safety of atorvastatin in major cardiovascular events: Meta-analysis].

Introduction: Atorvastatin has been used in the management of dyslipidemia and little is known about the efficacy and safety of high-dose atorvastatin administration for secondary prevention of Major Cardiovascular Events (MACE).

Objective: To evaluate the impact of high-dose atorvastatin on secondary prevention of MACE and adverse events.

Material and methods: A systematic review and meta-analysis of Pubmed, Embase, Bireme and Cochrane Library Plus databases was performed, with a time scope from 1990 to July 2022. Six randomized clinical trials were included with a total of 29,333 patients who were treated with 80 mg, 10 mg or placebo doses of Atorvastatin where the main outcomes evaluated were Major Cardiovascular Events (MACE), mortality and treatment safety.

Results: In the comparative study between the use of Atorvastatin 80 mg and other therapies, a relative risk (RR) of 0.8 (95%CI 0.69-0.92) was found, representing a 20% reduction in risk (RRR) and a number needed to treat (NNT) of 30-55. In the analysis of adverse effects, an RR of 2.37 (95% CI 0.86-6.53) and a number needed to harm (NNH) of 14-19 were observed. The use of 80 mg atorvastatin is associated with similar adverse events at lower doses.

Conclusions: The use of atorvastatin 80 mg is effective in the secondary prevention of Major Cardiovascular Event (MACE). The drug has adverse events that should be taken into account in secondary prevention.

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