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血清狄戈辛度的相关性和心力衰竭患者的结果

Saif S Rathore¹, Jeptha P Curtis, Yongfei Wang

¹The Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Conn 06520, USA.

|February 18, 2003

概括

在心力衰竭患者中,较高的血清狄戈辛度 (SDC) 与死亡率的增加有关. 迪戈辛治疗的最佳有效性可以在0.5-0.8 ng/mL之间的SDC中实现.

科学领域:

心脏病学心脏病学
药理学药理学是指药理学的学科.
临床试验临床试验

背景情况:

迪戈辛没有显示出死亡率的好处,但在心力衰竭患者中减少了住院的数量,心力衰竭患者的排泄分数减少.
之前对Digitalis Investigation Group (DIG) 试验的分析没有评估与特定血清狄戈辛度 (SDC) 相关的临床结果.

研究的目的:

研究不同血清狄戈辛度 (SDC) 与心力衰竭患者的死亡率和住院率之间的关联.
为了确定特定的SDC范围是否优化了迪戈辛素治疗的有效性.

主要方法:

随机,安慰剂控制的DIG试验 (1991-1995) 的特异后分析.
分析包括3782名左心室喷射率≤45%的男性,将狄戈辛组 (基于1个月的SDC:0.5-0.8,0.9-1.1,≥1.2 ng/mL) 与安慰剂进行比较.
主要终点是平均37个月的随访期间的全因死亡率.

主要成果:

增加的SDC与较高的原始全因死亡率相关 (0.5-0.8 ng/mL: 29.9%; 0.9-1.1 ng/mL: 38.8%; ≥1.2 ng/mL: 48.0%).
0.5-0.8 ng/mL的SDC与6.3%的死亡率降低有关,与安慰剂相比.
与安慰剂相比,SDC ≥1.2 ng/mL显示死亡率高11.8%,在多变量调整后仍然存在.

结论:

高血清狄戈辛度与心力衰竭患者的死亡率增加有关.
在患有心力衰竭和降低射出分数的男性中,迪戈辛治疗的有效性可以在SDC范围0.5到0.8 ng/mL内得到优化.

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