Eur Heart J：胆碱酯酶抑制剂或降阿尔茨海默型痴呆患者的心梗危险
2013-06-08 晓静 编译 医学论坛网
瑞典一项研究表明，胆碱酯酶抑制剂（ChEI）与阿尔茨海默型痴呆患者的心肌梗死和死亡危险降低相关，这种相关性随着ChEI剂量的增加而增强。相关论文6月4日在线发表于《欧州心脏杂志》（Eur Heart J）。 该队列研究入选了7073例平均年龄在79岁的阿尔茨海默型痴呆或伴有痴呆的阿尔茨海默病患者。结果在平均随访的503天期间，831例受试者发生看MI或死亡。校正混杂因
瑞典一项研究表明，胆碱酯酶抑制剂（ChEI）与阿尔茨海默型痴呆患者的心肌梗死和死亡危险降低相关，这种相关性随着ChEI剂量的增加而增强。相关论文6月4日在线发表于《欧州心脏杂志》（Eur Heart J）。
该队列研究入选了7073例平均年龄在79岁的阿尔茨海默型痴呆或伴有痴呆的阿尔茨海默病患者。结果在平均随访的503天期间，831例受试者发生看MI或死亡。校正混杂因素后，与不应用ChEI的受试者相比，应用ChEI的受试者复合事件终点危险降低了34%[比值比（HR）0.66] 。应用ChEI还与患者死亡和MI危险降低具有相关性（HR分别为0.64和0.62） 。应用最大推荐剂量的ChEI（多奈哌齐10 mg，卡巴拉汀 >6 mg，加兰他敏24 mg）与MI（HR0.35）或死亡危险（HR0.54）最低具有相关性。
AIMS
Cholinesterase inhibitors (ChEIs) are used for symptomatic treatment of Alzheimer's disease. These drugs have vagotonic and anti-inflammatory properties that could be of interest also with respect to cardiovascular disease. This study evaluated the use of ChEIs and the later risk of myocardial infarction and death.
METHODS AND RESULTS
The cohort consisted of 7073 subjects (mean age 79 years) from the Swedish Dementia Registry with the diagnoses of Alzheimer's dementia or Alzheimer's mixed dementia since 2007. Cholinesterase inhibitor use was linked to diagnosed myocardial infarctions (MIs) and death using national registers. During a mean follow-up period of 503 (range 0-2009) days, 831 subjects in the cohort suffered MI or died. After adjustment for confounders, subjects who used ChEIs had a 34% lower risk for this composite endpoint during the follow-up than those who did not [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.56-0.78]. Cholinesterase inhibitor use was also associated with a lower risk of death (HR: 0.64, 95% CI: 0.54-0.76) and MI (HR: 0.62, 95% CI: 0.40-0.95) when analysed separately. Subjects taking the highest recommended ChEI doses (donepezil 10 mg, rivastigmine >6 mg, galantamine 24 mg) had the lowest risk of MI (HR: 0.35, 95% CI: 0.19-0.64), or death (HR: 0.54, 95% CI: 0.43-0.67) compared with those who had never used ChEIs.
CONCLUSION
Cholinesterase inhibitor use was associated with a reduced risk of MI and death in a nationwide cohort of subjects diagnosed with Alzheimer's dementia. These associations were stronger with increasing ChEI dose.
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#阿尔茨海#
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#抑制剂#
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#痴呆患者#
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#阿尔茨#
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#ART#
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#阿尔茨海默#
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#胆碱酯酶#
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#胆碱#
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#HEART#
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