■预防中风是一个紧迫的全球卫生优先事项,减少血脂升高被认为是关键策略。东亚人,构成超过16亿个人和世界上最大的种族群体,是这项工作的关键人口。然而,在这一人群中,降脂疗法预防卒中的有效性仍不确定.
■我们对大型随机对照试验(RCT)进行了系统评价和荟萃分析,并进行了至少3年的随访,以评估降脂治疗对东亚人卒中发生率的长期影响。截至2024年1月11日,我们系统地搜索了四个电子数据库。使用相对风险(RR)和95%置信区间(CI)对关联进行量化,研究间异质性使用I2统计量进行评估。此外,我们使用Cochrane偏差风险工具评估每个纳入RCT的偏差风险,并应用GRADE方法评估证据的确定性.
■这项研究纳入了9项大规模随机对照试验的数据,涉及54,354名参与者。我们对总体分析的发现表明,降脂疗法并未显着影响所有中风的长期发病率(9项随机对照试验;54,354名参与者;RR,0.98[95%CI,0.87-1.10];P=0.75),缺血性卒中(7项随机对照试验;52,059名参与者;RR,0.91[95%CI,0.79-1.04];P=0.16),或出血卒中(7项随机对照试验;52,059名参与者;RR,东亚人1.24[95%CI,0.97-1.59];P=0.09)。值得注意的是,没有异质性或发表偏倚的证据,使用GRADE方法评估的证据质量被评为高。敏感性分析证实了我们结果的稳健性,没有一项研究显着影响总体结果。此外,亚组分析一致支持这些结论,进一步加强了我们研究的可靠性。
降脂疗法对东亚人的长期卒中预防没有任何有益作用。
UNASSIGNED: Stroke prevention is a pressing global health priority, with reducing elevated lipids recognized as a key strategy. East Asians, constituting more than 1.6 billion individuals and the largest racial group worldwide, are a key demographic in this effort. Yet, the effectiveness of lipid-lowering therapies for stroke prevention in this population remains uncertain.
UNASSIGNED: We conducted a systematic review and meta-analysis of large-scale randomized controlled trials (RCTs) with at least 3 years of follow-up to evaluate the long-term impact of lipid-lowering therapies on stroke incidence in East Asians. We systematically searched four electronic databases up to 11 January 2024. The association was quantified using relative risk (RR) with a 95% confidence interval (CI), and between-study heterogeneity was evaluated using the I2 statistic. In addition, we utilized the Cochrane Risk of Bias Tool to assess the risk of bias in each included RCT and applied the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to evaluate the certainty of the evidence.
UNASSIGNED: This study incorporated data from nine large-scale RCTs involving 54,354 participants. Our findings of overall analyses revealed that lipid-lowering therapies did not significantly affect the long-term incidence of all strokes (9 RCTs; 54,354 participants; RR = 0.98 (95% CI = 0.87-1.10); P = 0.75), ischemic stroke (7 RCTs; 52,059 participants; RR = 0.91 (95% CI, = 0.79-1.04); P = 0.16), or hemorrhage stroke (7 RCTs; 52,059 participants; RR = 1.24 (95% CI = 0.97-1.59); P = 0.09) in East Asians. Notably, there was no evidence of heterogeneity or publication bias, and the quality of evidence assessed using GRADE methodologies was rated as high. Sensitivity analyses confirmed the robustness of our results, with no single study significantly affecting the overall findings. Furthermore, subgroup analyses consistently supported the conclusions, further bolstering the reliability of our study.
UNASSIGNED: Lipid-lowering therapies did not demonstrate any beneficial effects on long-term stroke prevention among East Asians.