背景:临床指南推荐对大量心血管疾病患者使用他汀类药物。然而,除了他汀类药物外,关于伴随使用omega-3脂肪酸的证据不足.这项荟萃分析旨在揭示这种联合疗法对心血管结局的完整影响。脂质生物标志物,炎症标志物,和斑块标记。
方法:使用PubMed进行了详细的文献检索,科克伦,和MEDLINE数据库,并纳入了截至2023年9月的所有相关研究。本荟萃分析中评估的主要结局是1)致命和非致命心肌梗死的复合,2)致命和非致命中风的组合,3)冠状动脉血运重建,4)因心血管原因死亡,5)MACE(主要不良心血管事件),6)不稳定型心绞痛,7)不稳定型心绞痛住院,8)和脂质体积指数。次要结果包括脂质标志物,hsCRP,EPA水平,和EPA/AA比率。
结果:包括14项RCT,共有40,991名患者。接受omega-3+他汀类药物方案的患者与MI发生率的统计学显着降低相关,MACE,不稳定型心绞痛,因不稳定型心绞痛住院,总胆固醇水平,甘油三酯,hsCRP,和脂质体积指数与接受安慰剂+他汀类药物的同行相比(P<0.05)。相比之下,我们的分析发现,致命性和非致命性卒中的发生率没有统计学上的显著差异,冠状动脉血运重建,和心血管死亡率。
结论:我们的研究加强了所有患者,不管他们的心血管健康,可能受益于在他汀类药物治疗中添加omega-3脂肪酸。
BACKGROUND: Clinical guidelines recommend statin use in patients with a vast array of cardiovascular disturbances. However, there is insufficient evidence regarding the concomitant use of omega-3 fatty acids in addition to statins. This meta-analysis aims to uncover the complete effects of this combination therapy on cardiovascular outcomes, lipid biomarkers, inflammatory markers, and plaque markers.
METHODS: A detailed literature search was conducted using PubMed, Cochrane, and MEDLINE databases, and all the relevant studies found up to September 2023 were included. The primary outcomes assessed in this meta-analysis was 1) Composite of fatal and non-fatal myocardial infarction, 2) Composite of fatal and non-fatal stroke, 3) Coronary revascularization, 4) Death due to cardiovascular causes, 5) MACE (Major Adverse Cardiovascular Events), 6) Unstable angina, 7) Hospitalization due to unstable angina, 8) and lipid volume index. Secondary outcomes included lipid markers, hsCRP, EPA levels, and EPA/AA ratio.
RESULTS: 14 RCTs were included, featuring a total of 40,991 patients. Patients receiving the omega-3 + statin regimen were associated with a statistically significant decrease in the incidence of MI, MACE, unstable angina, hospitalization due to unstable angina, Total cholesterol levels, triglycerides, hsCRP, and lipid volume index in comparison to their counterparts receiving placebo + statin (P < 0.05). In contrast, our analysis found no statistically significant difference in the incidence of fatal and non-fatal stroke, coronary revascularization, and cardiovascular mortality.
CONCLUSIONS: Our research reinforces that all patients, regardless of their cardiovascular health, may benefit from adding omega-3 fatty acids to their statin therapy.