摘要
目的:比较匹伐他汀(4 mg/d)和阿托伐他汀(20 mg/d)对急性心肌梗死(AMI)伴糖代谢异常患者血脂与血糖水平的影响。方法:依托中国急性心肌梗死注册研究于2016年4月至2020年6月入组全国7个中心554例AMI患者,按1:1比例随机分配至匹伐他汀组与阿托伐他汀组,最终两组各有209例与203例符合条件入选。主要对比两组随访6个月时低密度脂蛋白胆固醇(LDL-C)与糖化血红蛋白(HbA_(1c))的变化,并将患者分为糖尿病与糖尿病前期进行亚组分析。结果:随访6个月时与基线相比,匹伐他汀组和阿托伐他汀组LDL-C([-0.6±0.8)mmol/L vs(.-0.9±1.0)mmol/L,P=0.082]和HbA_(1c)[(-0.6±1.5)%vs.(-0.3±1.1)%,P=0.090]的变化值差异均无统计学意义(P均>0.05);在合并糖尿病前期或糖尿病的匹伐他汀亚组和阿托伐他汀亚组中,LDL-C的变化值差异也均无统计学意义(P均>0.05),但合并糖尿病前期患者中阿托伐他汀亚组与匹伐他汀亚组相比,HbA_(1c)变化值差异有统计学意义[(0.2±0.4)%vs.(0.0±0.7)%,P=0.042]。结论:在AMI伴糖代谢异常患者中,匹伐他汀(4 mg/d)和阿托伐他汀(20 mg/d)降低LDL-C水平相似,但在糖尿病前期患者中匹伐他汀对HbA_(1c)的影响更小。
Objectives:To compare the effects of pitavastatin(4 mg/d)and atorvastatin(20 mg/d)on lipid and glucose levels in acute myocardial infarction(AMI)patients with abnormal glucose metabolism.Methods:A total of 209 patients were assigned to the pitavastatin group and 203 to the atorvastatin group.The primary endpoint was change in low density lipoprotein cholesterol(LDL-C)and glycosylated hemoglobin A_(1c)(HbA_(1c))at 6 months.The patients were further divided into diabetic and prediabetic subgroups for analysis.Results:In the overall population,there were similar differences in LDL-C([-0.6±0.8]mmol/L vs.[-0.9±1.0]mmol/L,P=0.082 for non-inferiority)and HbA_(1c)([-0.6±1.5]%vs.[-0.3±1.1]%,P=0.090)between pitavastatin and atorvastatin groups.Pitavastatin and atorvastatin were similar in lowering LDL-C in both prediabetic and diabetic patients,but the change in absolute HbA_(1c) was statistically significant between the two groups in prediabetic patients([0.0±0.7]%vs.[0.2±0.4]%,P=0.042),and in diabetic patients,the change in absolute HbA_(1c) was similar between the two groups.Conclusions:Pitavastatin 4 mg/d and atorvastatin 20 mg/d can reduce LDL-C similarly in patients with AMI and abnormal glucose metabolism.Pitavastatin has less effect on HbA_(1c) in patients with prediabetes.
作者
贺春晖
贺婷
杨进刚
于梅
苏淑红
杨红梅
胡喜田
高峰
史旭波
吴超
陶水英
张峻
吴元
乔树宾
吴永健
王杨
高晓津
杨跃进
中国急性心肌梗死注册研究组
HE Chunhui;HE Ting;YANG Jingang;YU Mei;SU Shuhong;YANG Hongmei;HU Xitian;GAO Feng;SHI Xubo;WU Chao;TAO Shuiying;ZHANG Jun;WU Yuan;QIAO Shubin;WU Yongjian;WANG Yang;GAO Xiaojin;YANG Yuejin;on Behalf of the Chinese Acute Myocardial Infarction Registry Group(Coronary Heart Disease Center,National Center for Cardiovascular Diseases and Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China;Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials,Animal Experimental Centre,National Center for Cardiovascular Diseases and Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China;Department of Cardiology,Langfang People's Hospital,Langfang 065000,China;Department of Cardiology,Xinxiang Central Hospital,Xinxiang 453099,China;Department of Cardiology,The First Hospital of Qinhuangdao,Qinhuangdao 066099,China;Department of Cardiology,People's Hospital Affiliated to Hebei Medical University,Shijiazhuang 050011,China;Department of Cardiovascular Medicine,Civil Aviation General Hospital,Beijing 100123,China;Cardiovascular Center,Beijing Tongren Hospital,Beijing 100005,China;Medical Research and Biometrics Center,National Center for Cardiovascular Diseases and Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China;不详)
出处
《中国循环杂志》
CSCD
北大核心
2023年第9期930-936,共7页
Chinese Circulation Journal
基金
国家“十二·五”科技支撑计划课题(2011BAI11B02)
中国医学科学院医学与健康科技创新工程项目(2020-I2M-C&T-B-050)。
关键词
急性心肌梗死
糖代谢异常
匹伐他汀
阿托伐他汀
糖化血红蛋白
acute myocardial infarction
abnormal glucose metabolism
pitavastatin
atorvastatin
glycated hemoglobin
