摘要
目的:评估在老年冠心病患者中应用依洛尤单抗降低LDL-C水平的安全性和有效性。方法:本研究采用前瞻性队列研究方法,连续纳入了207例LDL-C水平不达标(规律口服他汀类药物治疗至少4周后LDL-C≥2.3 mmol/L;或未规律口服他汀类药物LDL-C≥3.2 mmol/L)的老年冠心病患者,分为依洛尤单抗组(n=55)和对照组(n=152)。依洛尤单抗组在口服调脂治疗的基础上联合依洛尤单抗(每2周皮下注射140mg),观察两组患者随访12周时LDL-C的变化、心血管事件及不良事件发生率。结果:入组患者中既往未规律口服他汀类药物治疗者为102例(49.3%)。基线时依洛尤单抗组LDL-C水平明显高于对照组(P<0.001)。随访12周时,依洛尤单抗组LDL-C较基线的降幅明显高于对照组(P<0.001),且该组中LDL-C<1.8 mmol/L和<1.4 mmol/L的患者比例均明显高于对照组(均P<0.001)。两组患者间心血管事件、不良事件发生均无差异。结论:在这项评估依洛尤单抗用于老年冠心病患者的前瞻性队列研究中,他汀类药物联合依洛尤单抗治疗的耐受性良好,可使LDL-C水平大幅降低,有助于更多患者达到目前指南推荐的目标水平。
Objective:To evaluate the safety and efficacy of initiating evolocumab to reduce LDL-C levels in elderly patients with coronary heart disease(CAD).Methods:As a prospective cohort study,207 consecutive elderly CAD patients with substandard LDL-C levels(LDL-C≥2.3 mmol/L after at least 4 weeks of regular oral statin therapy;or LDL-C≥3.2 mmol/L without regular oral statin therapy)were divided into the evolocumab group(n=55)and the control group(n=152).Patients in the evolocumab group received evolocumab(140 mg subcutaneously every 2 weeks)combined with oral lipid-lowering therapy.The percentage change in LDL-C and the incidence of cardiovascular events and adverse events were observed at week 12.Results:49.28%of enrolled patients had not received regular statin therapy before.The LDL-C level of patients in the evolocumab group was significantly higher than control group at baseline(P<0.001).The LDL-C level of patients in the evolocumab group was significantly decreased at week 12(P<0.001).The proportions of patients with LDL-C<1.8 mmol/L and<1.4 mmol/L in the evolocumab group were significantly higher than those in the control group at week12(P<0.001).There were no significant differences in the incidence of cardiovascular events and adverse events between the two groups.Conclusions:In this prospective cohort study to assess the use of evolocumab in elderly patients with CAD,statin therapy combined with evolocumab is well tolerated and can significantly reduce LDL-C levels and help more patients reach the target level recommended by the current guidelines.
作者
雒芳芳
吴素萍
许晓晗
张维君
LUO Fangfang;WU Supiing;XU Xiaohan;ZHANG Weijun(Department of Clinical Nutrition,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)
出处
《心肺血管病杂志》
CAS
2022年第3期233-237,共5页
Journal of Cardiovascular and Pulmonary Diseases
关键词
依洛尤单抗
老年冠心病
低密度脂蛋白胆固醇
Evolocumab
Elderly patients with coronary heart disease
Low-density lipoprotein cholesterol
