Associations of omega-3 fatty acids vs. fenofibrate with adverse cardiovascular outcomes in people with metabolic syndrome: propensity matched cohort study.

IF 5.3 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Nam Hoon Kim, Ji Yoon Kim, Jimi Choi, Sin Gon Kim
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引用次数: 0

Abstract

Aims: Omega-3 fatty acids and fenofibrates have shown some beneficial cardiovascular effects; however, their efficacy has not been compared. This study aimed to compare the effectiveness of currently available omega-3 fatty acids and fenofibrate for reducing major adverse cardiovascular events (MACE).

Methods and results: From a nationwide population-based cohort in South Korea (2008-2019), individuals with metabolic syndrome (≥30 years) who received statin with omega-3 fatty acids and those receiving statin with fenofibrate were matched by propensity score (n = 39 165 in both groups). The primary outcome was MACE, including ischaemic heart disease (IHD), ischaemic stroke (IS), and death from cardiovascular causes. The risk of MACE was lower [hazard ratio (HR), 0.79; 95% confidence interval (CI), 0.74-0.83] in the fenofibrate group than in the omega-3 fatty acid group. Fenofibrate was associated with a lower incidence of IHD (HR, 0.72; 95% CI, 0.67-0.77) and hospitalization for heart failure (HR, 0.90; 95% CI, 0.82-0.97), but not IS (HR, 0.90; 95% CI, 0.81-1.00) nor death from cardiovascular causes (HR, 1.07; 95% CI, 0.97-1.17). The beneficial effect of fenofibrate compared to omega-3 fatty acids was prominent in patients with preexisting atherosclerotic cardiovascular disease and those receiving lower doses of omega-3 fatty acids (≤2 g per day).

Conclusion: In a real-world setting, fenofibrate use was associated with a lower risk of MACE compared with low-dose omega-3 fatty acids when added to statins in people with metabolic syndrome.

代谢综合征患者中omega-3脂肪酸与非诺贝特不良心血管结局的相关性:倾向匹配队列研究
目的:Omega-3脂肪酸和非诺贝特类已显示出对心血管有益的作用;然而,它们的功效还没有被比较过。本研究旨在比较目前可用的omega-3脂肪酸和非诺贝特在减少主要不良心血管事件(MACE)方面的有效性。方法和结果:来自韩国全国范围的人群队列(2008-2019),代谢综合征患者(≥30岁)接受他汀类药物联合omega-3脂肪酸和接受他汀类药物联合非诺贝特的个体通过倾向评分进行匹配(两组n = 39165)。主要终点为MACE,包括缺血性心脏病(IHD)、缺血性卒中(IS)和心血管原因死亡。MACE发生风险较低(HR, 0.79;95% CI, 0.74-0.83),非诺贝特组比omega-3脂肪酸组。非诺贝特与较低的IHD发生率相关(HR, 0.72;95% CI, 0.67-0.77)和心力衰竭住院(HR, 0.90;95% CI, 0.82-0.97),但IS没有(HR, 0.90;95% CI, 0.81-1.00)和心血管原因死亡(HR, 1.07;95% ci, 0.97-1.17)。与omega-3脂肪酸相比,非诺贝特的有益作用在先前存在动脉粥样硬化性心血管疾病的患者和接受低剂量omega-3脂肪酸(每天≤2克)的患者中表现突出。结论:在现实环境中,与低剂量omega-3脂肪酸相比,代谢综合征患者在他汀类药物中添加非诺贝特时,MACE风险较低。
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来源期刊
European Heart Journal - Cardiovascular Pharmacotherapy
European Heart Journal - Cardiovascular Pharmacotherapy Medicine-Cardiology and Cardiovascular Medicine
CiteScore
10.10
自引率
14.10%
发文量
65
期刊介绍: The European Heart Journal - Cardiovascular Pharmacotherapy (EHJ-CVP) is an international, peer-reviewed journal published in English, specifically dedicated to clinical cardiovascular pharmacology. EHJ-CVP publishes original articles focusing on clinical research involving both new and established drugs and methods, along with meta-analyses and topical reviews. The journal's primary aim is to enhance the pharmacological treatment of patients with cardiovascular disease by interpreting and integrating new scientific developments in this field. While the emphasis is on clinical topics, EHJ-CVP also considers basic research articles from fields such as physiology and molecular biology that contribute to the understanding of cardiovascular drug therapy. These may include articles related to new drug development and evaluation, the physiological and pharmacological basis of drug action, metabolism, drug interactions, and side effects.
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