在患有充血性心力衰竭的患者中,β-阻断剂治疗和血管酶转化酶缺失多态之间的药物遗传相互作用
D M McNamara1, R Holubkov, K Janosko
1Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. mcnamaradm@msx.upmc.edu
Circulation
|March 29, 2001
概括
而ACE D等位基因与心力衰竭存活率的恶化有关,尤其是在没有β-阻断剂治疗的情况下. β抑制剂可能会减轻ACE D等位基因对患者结局的负面影响.
科学领域:
- 心脏病学 心脏病学
- 药物遗传学 药物遗传学
- 遗传学 是一个遗传学.
背景情况:
- 氨酸和交感神经系统的激活会对心力衰竭的进展产生负面影响.
- 血管激素转化酶 (ACE) 缺失 (D) 基因与增加的氨酸-血管激素系统激活有关.
- 对ACE D等位基因对患者结局的影响及其与β抑制剂治疗的相互作用尚不清楚.
研究的目的:
- 调查ACE D等位基因与患有缩功能障碍的患者的无移植存活率之间的关联.
- 评估在心力衰竭患者中ACE基因型和β-抑制剂治疗之间的潜在药物遗传相互作用.
主要方法:
- 预期对328名患有缩功能障碍的患者进行随访.
- 基于ACE D/I多态 (II,ID,DD基因型) 的无移植生存率的评估.
- 根据ACE基因型分层分类的β-阻断剂治疗和不治疗的患者之间的生存率的比较.
主要成果:
- 患有ACE D等位基因的患者体现出明显较差的无移植生存率 (P=0.044).
- 在不接受β阻塞剂的患者中,ACE D等位基因的不良影响是明显的 (P=0.005).
- 在接受β抑制剂治疗的患者中,没有观察到ACE基因型对生存的显著影响 (P=0.73).
结论:
- 该ACE D等位基因与缩性功能障碍患者的无移植生存率降低有关.
- 这种关联主要是由没有接受β阻断剂治疗的患者驱动的.
- 研究结果表明,在心力衰竭管理中,ACE D/I多态和β-阻断剂治疗之间存在药物遗传相互作用.
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