Efficacy and safety of drugs in residual cardiovascular risk: A systematic review of the literature.
Int J Cardiol Cardiovasc Risk Prev
; 22: 200298, 2024 Sep.
Article
em En
| MEDLINE
| ID: mdl-38983606
ABSTRACT
Background:
The objective of this research is to evaluate the efficacy and safety of drugs in the residual risk in any of its three components lipid, inflammatory and thrombotic risk.Methods:
A systematic review was conducted of randomized clinical trials that included as a primary outcome, at least one of the conditions related to atherosclerotic cardiovascular disease. The databases used were PUBMED/MEDLINE, Scopus and ClinicalTrials.gov. The risk of bias of the studies was assessed using the Risk of Bias 2 tool.Results:
anddiscussion:
18 studies were included in the analysis. Half of the studies had low risk of bias or some concerns. Several drugs were effective in reducing the primaryoutcome:
ethyl eicosapentaenoeic acid (17.2 % E-EPA versus 22 % placebo HR 0.75; 95 % CI 0.68-0.83; p < 0.001), colchicine in stable coronary artery disease (6.8 % vs placebo 9.6 %, HR 0.59, 95 % CI 0.57-0.83; p < 0.001), Canakinumab (150 mg vs placebo ARR 15 %, HR 0.85, 95 % CI 0.74-0.98; p = 0.021) and Rivaroxaban with Aspirin in stable atherosclerotic disease (4.1 % versus aspirin 5.4 %, HR 0.76, 95 % CI 0.66-0.86, P < 0.001). Serious adverse events did not differ between study groups, except for a higher rate of bleeding with the use of combination antithrombotic therapy.Conclusion:
The residual risk can be reduced through the use of different drugs that act by modifying atherogenic lipid levels, modulating inflammatory pathways and the risk of thrombosis, with an acceptable safety profile in most studies.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
Int J Cardiol Cardiovasc Risk Prev
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Colômbia
País de publicação:
Holanda