PDF(Pubmed)
Abstract：
UNASSIGNED: To date, optimal agents for low-density lipoprotein cholesterol (LDL-C) reduction in patients with established atherosclerotic cardiovascular disease are still being explored. Thus, we evaluated the efficiency of novel LDL-C-lowering therapies in the secondary prevention of cardiovascular events.
UNASSIGNED: We included randomized clinical trials (RCTs) that explored the effects of different LDL-C lowering agents including alirocumab, evolocumab, and bempedoic acid in adult patients with cardiovascular disease. Several databases were searched from inception through 2022. The safety endpoint includes new-onset diabetes, serious adverse events, and neurocognitive disorders with at least 1 year of follow-up. The efficacy outcomes included composite adverse cardiovascular outcomes, all-cause death, and cardiovascular death.
UNASSIGNED: Seven RCTs comprising 53,106 patients were included in this research. Bempedoic acid ranked first in reducing the risk of new-onset diabetes (risk ratio [RR] 0.72, 95% credible interval [CrI] 0.52-0.99) and risk of the composite cardiovascular outcome (RR 0.75, 95% CrI 0.57-0.99). Meta-regression analysis demonstrated that elevated risk of new-onset diabetes was positively correlated with a significant reduction in LDL-C levels (p = 0.03). All treatment agents were associated with a decreased risk of a composite adverse cardiovascular outcome.
UNASSIGNED: The present analysis showed that bempedoic acid ranked first in reducing the risk of a composite cardiovascular outcome. In addition, it ranked first in reducing the risk of new-onset diabetes compared with placebo and evolocumab. Our analysis also suggests that the increased risk of new-onset diabetes might be associated with a reduction in LDL-C levels. Besides, the present analysis found that alirocumab ranked first in decreasing all-cause mortality and cardiovascular mortality.
UNASSIGNED: We included randomized clinical trials (RCTs) that explored the effects of different LDL-C lowering agents including alirocumab, evolocumab, and bempedoic acid in adult patients with cardiovascular disease. Several databases were searched from inception through 2022. The safety endpoint includes new-onset diabetes, serious adverse events, and neurocognitive disorders with at least 1 year of follow-up. The efficacy outcomes included composite adverse cardiovascular outcomes, all-cause death, and cardiovascular death.
UNASSIGNED: Seven RCTs comprising 53,106 patients were included in this research. Bempedoic acid ranked first in reducing the risk of new-onset diabetes (risk ratio [RR] 0.72, 95% credible interval [CrI] 0.52-0.99) and risk of the composite cardiovascular outcome (RR 0.75, 95% CrI 0.57-0.99). Meta-regression analysis demonstrated that elevated risk of new-onset diabetes was positively correlated with a significant reduction in LDL-C levels (p = 0.03). All treatment agents were associated with a decreased risk of a composite adverse cardiovascular outcome.
UNASSIGNED: The present analysis showed that bempedoic acid ranked first in reducing the risk of a composite cardiovascular outcome. In addition, it ranked first in reducing the risk of new-onset diabetes compared with placebo and evolocumab. Our analysis also suggests that the increased risk of new-onset diabetes might be associated with a reduction in LDL-C levels. Besides, the present analysis found that alirocumab ranked first in decreasing all-cause mortality and cardiovascular mortality.
摘要：
■到目前为止，目前仍在探索降低已确诊动脉粥样硬化性心血管疾病患者低密度脂蛋白胆固醇(LDL-C)的最佳药物.因此，我们评估了新型LDL-C降低疗法在心血管事件二级预防中的有效性.
■我们纳入了随机临床试验（RCT），这些试验探讨了包括alirocumab在内的不同LDL-C降低药物的作用，evolocumab,和bempedoic酸在成人心血管疾病患者中的作用。从成立到2022年，搜索了几个数据库。安全终点包括新发糖尿病，严重不良事件,和神经认知障碍至少1年的随访。疗效结果包括复合不良心血管结果，全因死亡,心血管死亡。
■7项RCTs包括53,106名患者纳入本研究。Bempedoicacid在降低新发糖尿病风险（风险比[RR]0.72，95％可信区间[CrI]0.52-0.99）和复合心血管结局风险（RR0.75，95％CrI0.57-0.99）方面排名第一。荟萃回归分析表明，新发糖尿病的风险升高与LDL-C水平的显着降低呈正相关（p=0.03）。所有治疗药物均与降低复合不良心血管结局的风险相关。
■目前的分析表明，bempedoicacid在降低复合心血管结局的风险方面排名第一。此外,与安慰剂和evolocumab相比,它在降低新发糖尿病风险方面排名第一.我们的分析还表明，新发糖尿病的风险增加可能与LDL-C水平降低有关。此外,本分析发现,alirocumab在降低全因死亡率和心血管死亡率方面排名第一.
■我们纳入了随机临床试验（RCT），这些试验探讨了包括alirocumab在内的不同LDL-C降低药物的作用，evolocumab,和bempedoic酸在成人心血管疾病患者中的作用。从成立到2022年，搜索了几个数据库。安全终点包括新发糖尿病，严重不良事件,和神经认知障碍至少1年的随访。疗效结果包括复合不良心血管结果，全因死亡,心血管死亡。
■7项RCTs包括53,106名患者纳入本研究。Bempedoicacid在降低新发糖尿病风险（风险比[RR]0.72，95％可信区间[CrI]0.52-0.99）和复合心血管结局风险（RR0.75，95％CrI0.57-0.99）方面排名第一。荟萃回归分析表明，新发糖尿病的风险升高与LDL-C水平的显着降低呈正相关（p=0.03）。所有治疗药物均与降低复合不良心血管结局的风险相关。
■目前的分析表明，bempedoicacid在降低复合心血管结局的风险方面排名第一。此外,与安慰剂和evolocumab相比,它在降低新发糖尿病风险方面排名第一.我们的分析还表明，新发糖尿病的风险增加可能与LDL-C水平降低有关。此外,本分析发现,alirocumab在降低全因死亡率和心血管死亡率方面排名第一.
