Effect of Randomized Lipid Lowering With Simvastatin and Ezetimibe on Cataract Development (from the Simvastatin and Ezetimibe in Aortic Stenosis Study).

摘要: Recent American College of Cardiology/American Heart Association guidelines on statin initiation the basis total atherosclerotic cardiovascular disease risk argue that preventive effect statins events outweigh side effects, although this is controversial. Studies indicate a possible therapy reducing lens opacities. However, results are conflicting. The Simvastatin and Ezetimibe in Aortic Stenosis study (NCT00092677) enrolled 1,873 patients with asymptomatic aortic stenosis no history diabetes, coronary heart disease, or other serious co-morbidities were randomized (1:1) to double-blind 40 mg simvastatin plus 10 ezetimibe versus placebo. primary end point substudy was incident cataract. Univariate multivariate Cox models used analyze: (1) if active treatment reduced (2) time-varying low-density lipoproteins (LDL) cholesterol lowering (annually assessed) associated less cataract per se. During an average follow-up 4.3 years, 65 (3.5%) developed Mean age at baseline 68 years 39% women. In analysis adjusted for age, gender, prednisolone treatment, smoking, LDL high sensitivity C-reactive protein; placebo 44% lower development (hazard ratio 0.56, 95% confidence interval 0.33 0.96, p = 0.034). parallel substituting LDL-cholesterol intreatment itself 0.78 1 mmol/ml cholesterol, 0.64 0.93, 0.008). conclusion, development. This should perhaps be considered risk-benefit treatment.