PDF(Pubmed)
Abstract：
UNASSIGNED: The objective of this research is to evaluate the efficacy and safety of drugs in the residual risk in any of its three components: lipid, inflammatory and thrombotic risk.
UNASSIGNED: A systematic review was conducted of randomized clinical trials that included as a primary outcome, at least one of the conditions related to atherosclerotic cardiovascular disease. The databases used were PUBMED/MEDLINE, Scopus and ClinicalTrials.gov. The risk of bias of the studies was assessed using the Risk of Bias 2 tool.
UNASSIGNED: and discussion: 18 studies were included in the analysis. Half of the studies had low risk of bias or some concerns. Several drugs were effective in reducing the primary outcome: ethyl eicosapentaenoeic acid (17.2 % E-EPA versus 22 % placebo HR: 0.75; 95 % CI 0.68-0.83; p < 0.001), colchicine in stable coronary artery disease (6.8 % vs placebo 9.6 %, HR 0.59, 95 % CI 0.57-0.83; p < 0.001), Canakinumab (150 mg vs placebo ARR 15 %, HR 0.85, 95 % CI 0.74-0.98; p = 0.021) and Rivaroxaban with Aspirin in stable atherosclerotic disease (4.1 % versus aspirin 5.4 %, HR 0.76, 95 % CI 0.66-0.86, P < 0.001). Serious adverse events did not differ between study groups, except for a higher rate of bleeding with the use of combination antithrombotic therapy.
UNASSIGNED: The residual risk can be reduced through the use of different drugs that act by modifying atherogenic lipid levels, modulating inflammatory pathways and the risk of thrombosis, with an acceptable safety profile in most studies.
UNASSIGNED: A systematic review was conducted of randomized clinical trials that included as a primary outcome, at least one of the conditions related to atherosclerotic cardiovascular disease. The databases used were PUBMED/MEDLINE, Scopus and ClinicalTrials.gov. The risk of bias of the studies was assessed using the Risk of Bias 2 tool.
UNASSIGNED: and discussion: 18 studies were included in the analysis. Half of the studies had low risk of bias or some concerns. Several drugs were effective in reducing the primary outcome: ethyl eicosapentaenoeic acid (17.2 % E-EPA versus 22 % placebo HR: 0.75; 95 % CI 0.68-0.83; p < 0.001), colchicine in stable coronary artery disease (6.8 % vs placebo 9.6 %, HR 0.59, 95 % CI 0.57-0.83; p < 0.001), Canakinumab (150 mg vs placebo ARR 15 %, HR 0.85, 95 % CI 0.74-0.98; p = 0.021) and Rivaroxaban with Aspirin in stable atherosclerotic disease (4.1 % versus aspirin 5.4 %, HR 0.76, 95 % CI 0.66-0.86, P < 0.001). Serious adverse events did not differ between study groups, except for a higher rate of bleeding with the use of combination antithrombotic therapy.
UNASSIGNED: The residual risk can be reduced through the use of different drugs that act by modifying atherogenic lipid levels, modulating inflammatory pathways and the risk of thrombosis, with an acceptable safety profile in most studies.
摘要：
■这项研究的目的是评估药物在其三种成分中的任何一种中的残留风险中的功效和安全性：脂质，炎症和血栓形成的风险。
■对随机临床试验进行了系统评价，包括作为主要结果，至少一种与动脉粥样硬化性心血管疾病相关的疾病。使用的数据库是PUBMED/MEDLINE，ScopusandClinicalTrials.gov.使用偏差风险2工具评估研究的偏差风险。
■和讨论：分析中包括18项研究。一半的研究有较低的偏倚风险或一些担忧。几种药物可有效降低主要结局：二十碳五烯酸乙酯（17.2％E-EPA对22％安慰剂HR：0.75；95％CI0.68-0.83；p<0.001），秋水仙碱治疗稳定型冠状动脉疾病（6.8%vs安慰剂9.6%，HR0.59，95%CI0.57-0.83；p<0.001)，Canakinumab（150mgvs安慰剂ARR15％，HR0.85,95%CI0.74-0.98;p=0.021)和利伐沙班联合阿司匹林治疗稳定性动脉粥样硬化疾病(4.1%vs阿司匹林5.4%,HR0.76，95%CI0.66-0.86，P<0.001）。严重不良事件在研究组之间没有差异。除了使用联合抗血栓治疗的出血率更高。
■可以通过使用通过改变动脉粥样硬化脂质水平起作用的不同药物来降低残余风险，调节炎症途径和血栓形成的风险，在大多数研究中具有可接受的安全性。
■对随机临床试验进行了系统评价，包括作为主要结果，至少一种与动脉粥样硬化性心血管疾病相关的疾病。使用的数据库是PUBMED/MEDLINE，ScopusandClinicalTrials.gov.使用偏差风险2工具评估研究的偏差风险。
■和讨论：分析中包括18项研究。一半的研究有较低的偏倚风险或一些担忧。几种药物可有效降低主要结局：二十碳五烯酸乙酯（17.2％E-EPA对22％安慰剂HR：0.75；95％CI0.68-0.83；p<0.001），秋水仙碱治疗稳定型冠状动脉疾病（6.8%vs安慰剂9.6%，HR0.59，95%CI0.57-0.83；p<0.001)，Canakinumab（150mgvs安慰剂ARR15％，HR0.85,95%CI0.74-0.98;p=0.021)和利伐沙班联合阿司匹林治疗稳定性动脉粥样硬化疾病(4.1%vs阿司匹林5.4%,HR0.76，95%CI0.66-0.86，P<0.001）。严重不良事件在研究组之间没有差异。除了使用联合抗血栓治疗的出血率更高。
■可以通过使用通过改变动脉粥样硬化脂质水平起作用的不同药物来降低残余风险，调节炎症途径和血栓形成的风险，在大多数研究中具有可接受的安全性。
