New Study Strengthens Evidence of the Connection Between Statin Use and Cataracts; But Any Risks Should be Weighed Against Benefits

Philadelphia, PA, December 3, 2014 /3BL Media/ – Few classes of drugs have had such a transformative effect on the prevention of cardiovascular disease (CVD) as have statins, prescribed to reduce total cholesterol and low-density lipoprotein cholesterol. However, some clinicians have ongoing concerns regarding the potential for lens opacities (cataracts) as a result of statin use. In an article in the加拿大心脏病学杂志，研究人员报告说，接受他汀类药物治疗的患者的白内障风险增加。随附的社论讨论了他汀类药物的历史，并在以前对他汀类药物使用引起的不良反应分析的结果相互矛盾的结果中定位了这项新研究。

在先前的研究中，他汀类药物使用和白内障之间的关联是不一致的且有争议的。当前的研究使用了2000 - 2007年的不列颠哥伦比亚省卫生数据库的数据和2001 - 2011年IMS Lifelink美国数据库，以组成两个患者同伙。BC队列由女性和男性患者组成。将162,501例与650,004个对照匹配。IMS LIFELINK队列仅由男性组成，年龄40-85；45,065例与450,650个对照匹配。在初次眼科​​检查之前，使用他汀类药物使用他汀类药物一年多。遵循白内障的诊断和手术管理。

在卑诗省队列中，大约增加了需要手术干预的白内障风险增加了27％（调整风险比，RR = 1.27）。在IMS队列中，风险的增加仅为7％，但仍然具有统计意义。

在BC队列中长期定期使用特定汀类药物的调整后RR范围为1.14至1.42。在IMS队列中，单个汀类药物的调整后RR在狭窄范围内从1.03到1.14不等。研究人员没有确定某些他汀类药物是否比其他汀类药物更糟，但是大多数置信区间都重叠表明会产生班级效应。

首席研究员G.B.加拿大不列颠哥伦比亚大学医学院医学院医学系医学博士约翰·曼奇尼（John Mancini）指出，“建议进一步评估这种关系的临床影响，尤其是鉴于他汀类药物用于汀类药物对CVD初级预防的增加使用以及在CVD很普遍的老年中可接受的视觉的重要性。还必须解决解决该关联可能的基本机制的未来研究。但是，由于RR较低，并且由于白内障手术既有效且耐受性良好，因此应披露该关联，但在保证降低CV风险时，不认为使用他汀类药物的使用。”

在伴随的社论中，史蒂文·格林（Steven Gryn），医学博士史蒂文·格林（Steven Gryn），弗朗西（FRCPC）和罗伯特·阿格勒（Robert A.

这y write, “Any medication that has beneficial effects has potential adverse effects; weighing the benefits against the risks is an integral part of the informed consent process, and is central to any decision to initiate treatment. Among patients who are at high CVD risk, like most of those seen by cardiologists…the prevention of CVD, stroke, and their associated morbidity and mortality vastly outweighs the risk of cataracts. Even among lower risk patients, for whom the benefit-risk ratio is less dramatic, most patients would still probably prefer having to undergo earlier non-life-threatening cataract surgery over suffering a major vascular event.”

In any observational study, there can be unknown confounders that could introduce bias. Both the study itself and the commentary note this weakness, but both agree that this study, while not putting the issue to rest, does add significantly to the accumulated knowledge about the statin-cataract connection. However, as Dr. Hegele notes, "A randomized double-blinded placebo-controlled clinical trial is the best way to mitigate confounding, and such studies so far have shown no association of statins with cataracts."

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编辑的注释
“汀类药物的使用和风险：加拿大和美国的两个人群的嵌套病例对照研究”，Stephanie J. Wise MD，Nawaaz A. Nathoo A.FRCSC和G. B. John Mancini MD，FRCPC，FACP，FACC，DOI：http://dx.doi.org/10.1016/j.cjca.2014.08.020。

社论：“医生我的眼睛：他汀类药物的连接？”史蒂文·格林（Steven Gryn），医学博士，FRCPC和Robert A. Hegele，医学博士，FRCPC，DOI：http://dx.doi.org/10.1016/j.cjca.2014.08.019。

两者都出现在加拿大心脏病学杂志，，，，Volume 30, Issue 12 (December 2014), published by Elsevier.

本文的全文和社论可应要求提供凭证记者。请致电+1 732 238 3628与Eileen Leahy联系或cjcmedia@elsevier.com获得副本。希望采访曼奇尼博士的记者可以直接致电+1 604 875 5477或mancini@mail.ubc.ca。Contact Dr. Hegele athegele@robarts.ca。

About the加拿大心脏病学杂志
这加拿大心脏病学杂志（（www.onlinecjc.ca) is the official journal of the Canadian Cardiovascular Society (www.ccs.ca). It is a vehicle for the international dissemination of new knowledge in cardiology and cardiovascular science, particularly serving as a major venue for the results of Canadian cardiovascular research and Society guidelines. The journal publishes original reports of clinical and basic research relevant to cardiovascular medicine as well as editorials, review articles, case reports, and papers on health outcomes, policy research, ethics, medical history, and political issues affecting practice.

About the editor-in-chief
Editor-in-Chief Stanley Nattel, MD, is Paul-David Chair in Cardiovascular Electrophysiology and Professor of Medicine at the University of Montreal and Director of the Electrophysiology Research Program at the Montreal Heart Institute Research Center.

关于加拿大心血管社会
加拿大心血管学会是加拿大心血管医师和科学家的专业协会，致力于通过知识翻译，专业发展和卫生政策领导才能促进心血管健康和护理。CCS为其1900多名成员和心血管社区中的其他成员提供计划和188bet上不了服务，包括心血管护理指南，每年的加拿大心血管大会，以及加拿大心血管学院的学院，对受训者的计划。188bet网址怎么打不开有关CCS及其活动的更多信息可以在www.ccs.ca。

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