Käypä hoito -kuvat
Käypä hoito -työryhmä Dyslipidemiat
27.10.2020
Molemmat luvut on laskettu tutkimuksen keskimääräistä kestoaikaa kohden. Useimmiten
kestoaika on ollut noin 5 vuotta. Koska JUPITER-tutkimus oli kestoltaan selvästi lyhyempi
(mediaani vain 1,9 vuotta), siitä on esitetty sekä 2:ta että 5:ttä vuotta kohden lasketut
luvut «Ridker PM, Danielson E, Fonseca FA ym. Rosuvastati...»2. HPS1 = merkittävät sepelvaltimotautitapahtumat Heart Protection Studyssa, HPS2 =
sepelvaltimo- ja aivovaltimotautitapahtumat Heart Protection Studyssa «Heart Protection Study Collaborative Group. MRC/BH...»3.
Kuviosta voidaan päätellä, että
- hoidosta saatava absoluuttinen hyöty on sitä suurempi, mitä suurempi kardiovaskulaaritapahtumien
riski on
- tulokset sijoittuvat varsin hyvin samalle uralle, olipa dyslipidemiaa hoidettu kolestyramiinilla
(LRC), fibraatilla (HHS, VA-HIT) tai statiinilla (kaikki muut tutkimukset)
- muista selvästi poikkeavia tuloksia voi selittää pieni LDL-kolesterolipitoisuuden
nettoero hoito- ja verrokkiryhmän välillä (ALLHAT) tai komplisoitu kohderyhmä (sydämen
vajaatoimintapotilaat CORONA-tutkimuksessa)
- NNT-lukua arvioitaessa on otettava huomioon hoidon kesto (JUPITER-tutkimuksen 2 ja
5 vuoden tulokset. Ks. «Kassai B, Gueyffier F, Boissel JP ym. Absolute ben...»1)
Taulukko 1. Tutkimuksista käytetyt lyhenteet
AFCAPS/TexCAPS |
Air Force / Texas Coronary Atherosclerosis Prevention Study |
«Downs JR, Clearfield M, Weis S ym. Primary prevent...»4 |
ALLHAT |
Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial |
«ALLHAT Officers and Coordinators for the ALLHAT Co...»5 |
ALERT |
Assessment of Lescol in Renal Transplantation |
«Holdaas H, Fellström B, Jardine AG ym. Effect of f...»6 |
ASCOT |
Anglo-Scandinavian Cardiac Outcomes Trial |
«Sever PS, Dahlöf B, Poulter NR ym. Prevention of c...»7 |
ASPEN |
Atorvastatin Study for Prevention of coronary heart disease Endpoints in Non-insulin-dependent
diabetes mellitus
|
«Knopp RH, d'Emden M, Smilde JG ym. Efficacy and sa...»8 |
CARE |
Cholesterol And Recurrent Events |
«Sacks FM, Pfeffer MA, Moye LA ym. The effect of pr...»13 |
HPS |
Heart Protection Study |
«Heart Protection Study Collaborative Group. MRC/BH...»3 |
HHS |
Helsinki Heart Study |
«Frick MH, Syvänne M, Nieminen MS ym. Prevention of...»22 |
JUPITER |
Justification for the Use of statins in Primary prevention: an Intervention Trial
Evaluating Rosuvastatin
|
«Ridker PM, Danielson E, Fonseca FA ym. Rosuvastati...»2 |
LIPID |
Long-term Intervention with Pravastatin in Ischemic Disease |
«Prevention of cardiovascular events and death with...»25 |
LIPS |
Lescol Intervention Prevention Study |
«Serruys PW, de Feyter P, Macaya C ym. Fluvastatin ...»26 |
LRC-CPPT |
Lipid Research Clinics - Cholestyramine Primary Prevention Trial |
«The Lipid Research Clinics Coronary Primary Preven...»28 |
PROSPER |
Prospective Study of Pravastatin in the Elderly at Risk |
«Shepherd J, Blauw GJ, Murphy MB ym. Pravastatin in...»31 |
SPARCL |
Stroke Prevention by Aggressive Reduction in Cholesterol Levels |
«Amarenco P, Goldstein LB, Szarek M ym. Effects of ...»36 |
VA-HIT |
Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial |
«Bloomfield Rubins H, Davenport J, Babikian V ym. R...»38 |
WOSCOPS |
West Of Scotland Coronary Prevention Study |
«Shepherd J, Cobbe SM, Ford I ym. Prevention of cor...»39 |
4S |
Scandinavian Simvastatin Survival Study |
«Randomised trial of cholesterol lowering in 4444 p...»40 |
Kirjallisuutta
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26.10.08
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