Lancet:高敏C反应蛋白浓度可预测康纳单抗治疗后心肌梗死患者预后

2017-11-14 zhangfan MedSci原创

研究发现高敏C反应蛋白浓度是评估康纳单抗治疗效果的有效方法,炎症指标越低的患者,其接受康纳单抗治疗的效果越好

白细胞介素1β单克隆抗体康纳单抗可减少炎症和心血管事件发生率,但对脂质代谢无影响。近日研究人员在接受康纳单抗治疗的患者考察了炎症标志物高敏C反应蛋白(hsCRP)水平与临床收益之间的关系。

本次研究是对CANTOS临床试验的二次分析,10061名心肌梗死史患者参与研究,随机接受康纳单抗(50 mg, 150 mg或300 mg)或安慰剂。通过主要不良心血管事件、心血管死亡率和全因死亡率考察治疗的有效性,同时将治疗效果与患者hsCRP水平相关联。研究平均随访3.7年。

组间患者基线疾病特征无显著差异。治疗组中,患者hsCRP浓度低于2 mg/L其主要心血管不良事件降低25% (多变量调整危险比[HRadj]=0.75,95% CI 0.66-0.85), 对于hsCRP 浓度高于2 mg/L 的患者,则无显著的临床收益。(HRadj=0.90,0.79-1.02)。对于hsCRP浓度低于2 mg/L的治疗组成员,心血管死亡(HRadj=0.69,95% CI 0.56-0.85)以及全因死亡风险(HRadj=0.69,0.58-0.81) 分别降低了31%, hsCRP 浓度高于2 mg/L 的患者无显著的临床收益。其他次要终点事件,如不稳定型心绞痛住院和需要计划外血运重建;敏感性分析结果如hsCRP平均减少量、hsCRP减少50%及以上、hsCRP减少患者百分比;剂量特异性分析等方面表现出类似的结果。

研究发现高敏C反应蛋白浓度是评估康纳单抗治疗效果的有效方法,炎症指标越低的患者,其接受康纳单抗治疗的效果越好。

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    2018-09-22 howi
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    2017-11-14 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0