UNASSIGNED:尽管最近的一项研究报道贝特类药物与心血管疾病(CV)死亡的低风险相关,并且可以推迟晚期慢性肾病(CKD)患者长期血液透析的需要,关于贝特类药物的CV保护作用是否扩展到终末期肾病(ESRD)患者,目前尚不清楚.本研究比较了接受贝特类药物治疗的ESRD患者的CV结局和死亡率,他汀类药物,两者都不是,或他们的组合。
UNASSIGNED:这项队列研究从台湾的国家健康保险研究数据库(NHIRD)中提取数据。确定患有ESRD和高脂血症的成年患者,并将其分为四组(贝特,他汀类药物组合,和非使用者组)根据他们在永久透析开始前3个月内使用不同的降脂疗法。使用治疗加权的逆概率来平衡各组的基线特征。随访结果是全因死亡率,CV死亡,和主要不良心脑血管事件(MACCEs)。
UNASSIGNED:与非使用者和他汀类药物组相比,贝特类药物组的全因死亡率风险没有显著降低[贝特类药物与非使用者:危险比(HR),0.97;95%置信区间(CI),0.92-1.03;他汀类药物与贝特:HR,0.95;95%CI,0.90-1.01],CV死亡(贝特与非用户:HR,0.97;95%CI,0.90-1.05;他汀类药物与贝特:HR,0.97;95%CI,0.90-1.06),和MACCEs(贝特与非用户:HR,1.03;95%CI,0.96-1.10;他汀类药物与贝特:HR,0.94;95%CI,0.87-1.004)。贝特类药物和他汀类药物(特别是中度至高效他汀类药物)的组合并未降低全因死亡率的风险。CV死亡,或MACCE与单独的他汀类药物相比。
未经证实:ESRD患者,使用贝特类药物可能与降低死亡率或心血管风险无关,无论它们是单独使用还是与他汀类药物联合使用。
UNASSIGNED: Although a recent
study reported that
fibrates are associated with a low risk of cardiovascular (CV) death and can postpone the need for long-term hemodialysis in patients with advanced chronic kidney disease (CKD), little is known regarding whether the CV protective effects of
fibrates extend to patients with end-stage renal disease (ESRD). The present
study compared CV outcomes and mortality among patients with ESRD treated with
fibrates, statins, neither, or their combination.
UNASSIGNED: This cohort
study extracted data from Taiwan\'s National Health Insurance Research Database (NHIRD). Adult patients with ESRD and hyperlipidemia were identified and categorized into four groups (fibrate, statin, combination, and non-user groups) according to their use of different lipid-lowering therapies within 3 months prior to the commencement of permanent dialysis. Inverse probability of treatment weighting was used to balance the baseline characteristics of the groups. The follow-up outcomes were all-cause mortality, CV death, and major adverse cardiac and cerebrovascular events (MACCEs).
UNASSIGNED: Compared with the non-user and statin groups, the fibrate group did not exhibit significantly lower risks of all-cause mortality [fibrate vs. non-user: hazard ratio (HR), 0.97; 95% confidence interval (CI), 0.92-1.03; statin vs. fibrate: HR, 0.95; 95% CI, 0.90-1.01], CV death (fibrate vs. non-user: HR, 0.97; 95% CI, 0.90-1.05; statin vs. fibrate: HR, 0.97; 95% CI, 0.90-1.06), and MACCEs (fibrate vs. non-user: HR, 1.03; 95% CI, 0.96-1.10; statin vs. fibrate: HR, 0.94; 95% CI, 0.87-1.004). The combination of fibrates and statins (specifically moderate- to high-potency statins) did not result in lower risks of all-cause mortality, CV death, or MACCEs compared with statins alone.
UNASSIGNED: In patients with ESRD, the use of
fibrates might be not associated with reduced mortality or CV risks, regardless of whether they are used alone or in combination with statins.