慢性心力衰竭患者运动训练的有效性和安全性:HF-ACTION随机对照试验
Christopher M O'Connor1, David J Whellan, Kerry L Lee
1Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715, USA. oconn002@mc.duke.edu
JAMA
|April 9, 2009
概括
在初级分析中,运动训练没有显著减少心力衰竭患者的死亡率或住院时间. 然而,经过调整后的分析显示,运动在降低死亡率和住院病例方面具有适度的显著益处.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
- 临床试验 临床试验
背景情况:
- 指导方针建议对稳定的心力衰竭门诊患者进行运动训练.
- 以前的研究缺乏评估炼训练对临床结果的影响的能力.
研究的目的:
- 评估心力衰竭患者运动训练的有效性和安全性.
- 为了确定运动训练是否影响死亡率和住院率.
主要方法:
- 一个多中心,随机对照试验 (HF-ACTION) 涉及2331名心力衰竭患者.
- 干预组接受了通常的护理加上有氧运动训练;对照组仅接受了通常的护理.
- 主要终点:综合所有原因死亡率或住院;次要终点:死亡率和住院亚型.
主要成果:
- 主要分析显示,所有原因的死亡率或住院治疗率没有显著降低 (HR,0.93;P=13).
- 二级终点在初级分析中也显示了不显著的减少.
- 调整后的分析显示,所有原因死亡率或住院治疗 (HR,0.89;P=.03) 和心血管死亡率或心血管疾病住院治疗 (HR,0.85;P=.03) 显著减少.
结论:
- 协议规定的初级分析表明,运动训练对死亡率或住院治疗没有显著的益处.
- 经过调整后的分析表明,运动训练对心力衰竭患者的特定临床结果可能具有适度的显著益处.
- 在运动和通常护理组之间,不良事件是相似的.
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