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【medical-news】初始行他汀治疗后，胆固醇监测频
Therefore, "current guidelines that recommend annual or more frequent monitoring should be reconsidered," conclude Dr. Paul P. Glasziou from the University of Oxford, UK and colleagues in a report in the May 6th issue of the Annals of Internal Medicine.
"After the initial decrease in cholesterol level in response to treatment (perhaps with dose titration to reach a target value) ... retesting adherent patients every 3 to 5 years may be sufficient," they write.
Dr. Glasziou and colleagues analyzed cholesterol measurement data from 9,014 participants in the Long-term Intervention with Pravastatin in Ischemic Disease (LIPID) study. As part of the study, cholesterol levels were obtained at randomization to pravastatin 40 mg or placebo and again at 6 and 12 months and then annually to 5 years.
Results showed that during the first 4 years of statin therapy, the random fluctuation in cholesterol levels -- the "noise" -- was greater than the long-term effect of the drug -- the "signal."
The data suggest that the "signal-to-noise ratio in cholesterol level monitoring is weak," the investigators note, adding that it takes "approximately 3 years before plausible changes in true cholesterol values could be comparable with the short-term variation - that is, before 'signal' equals 'noise.'"
Specifically, they found that the short-term variability of measurement was about -0.80 to 0.80 mmol/L (-31 to 31 mg/dL). "Our calculations suggest that, for patients with levels that are 0.5 mmol/L or more (greater than or equal to 19 mg/dL) under target, monitoring is likely to detect many more false-positive results than true-positive results for at least the first 3 years after treatment has commenced."
"The key message is that we probably monitor cholesterol too often," Dr. Glasziou noted in comments to Reuters Health. "Most of the apparent change is just measurement error and true change is much slower than we expect."
Ann Intern Med 2008;148:656-661. Less Frequent Cholesterol Checks Okay After Statin Initiation: Study
http://www.mphtimes.com/bbs/viewthread.php?tid=181&extra=page%3D1
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作者:admin@医学,生命科学 2010-12-01 05:11
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