最近心肌梗塞后患者的死亡率:一种随机的,安慰剂对照的阿齐米利德试验,使用心率可变性来确定风险分层
A John Camm1, Craig M Pratt, Peter J Schwartz
1Department of Cardiology, St George's Hospital, London, UK. jcamm@sghms.ac.uk
Circulation
|February 18, 2004
概括
阿齐米利德在心肌梗塞后患有左心室功能丧或心率变化低的患者的死亡率上没有影响. 低心率变化独立识别的高风险患者.
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:
- 抑郁的左心室功能 (LVF) 和低心率变化 (HRV) 与心肌梗塞 (MI) 后死亡率的增加有关.
- 亚齐米利德是一种新型III类抗失常药,它对这些高风险患者群体的死亡率的影响进行了评估.
研究的目的:
- 为了研究阿齐米利德对所有原因死亡率的影响,在心脏病后的患有抑郁的LVF的患者中.
- 评估阿齐米利德在低HRV的子群体中的疗效,这是增加死亡风险的标志物.
主要方法:
- 一项随机,双盲,安慰剂控制的研究,涉及3717名心脏病后心脏病患者,患有抑郁的LVF.
- 患者接受阿齐米利德100毫克或安慰剂,死亡率评估为1年.
主要成果:
- 在患有抑郁性LVF (12%对12%) 或低HRV (14%对15%) 的患者中,阿齐米利德没有显著改变全因死亡率.
- 低HRV患者的1年死亡率明显高于高HRV患者 (15%vs9.5%).
- 阿齐米利德的使用与心房的发病率较低有关,但胸部尖和严重中性质衰竭的发病率略高.
结论:
- 阿齐米利德在心脏病发作后的患有压抑的LVF或低HRV的患者的死亡率方面没有显著的益处或危害.
- 低HRV被证实是心脏病发作后死亡风险增加的独立预测因子.
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