伊瓦布拉丁和慢性心力衰竭 (SHIFT) 的结果:一个随机的安慰剂受控研究
Karl Swedberg1, Michel Komajda, Michael Böhm
1Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden. karl.swedberg@gu.se
Lancet (London, England)
|August 31, 2010
概括
使用 ivabradine 降低心率显著改善了慢性心力衰竭患者的临床结果. 这项研究证实了心率在心力衰竭病理生理学中的作用,减少了心血管死亡和住院治疗.
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.
背景情况:
- 慢性心力衰竭具有显著的死亡率和发病率.
- 休息时心率升高是心力衰竭患者不良结果的已知危险因素.
- 选择性鼻节抑制剂伊瓦布拉丁向心率降低.
研究的目的:
- 评估艾瓦布拉丁降低心率对症状心力衰竭患者临床结果的影响.
- 评估伊瓦布拉丁在减少心血管死亡和因心力衰竭恶化而入院的疗效.
- 确认心率在心力衰竭病理生理学中的作用.
主要方法:
- 一个随机的,双盲的,安慰剂控制的平行组研究.
- 纳入标准:症状性心力衰竭,LVEF ≤35%,鼻节律HR ≥70 bpm,最近因心力衰竭住院治疗,背景治疗稳定.
- 患者接受了对7.5毫克两日两次或安慰剂进行定位的伊瓦布拉丁;主要终点是心血管死亡或心力衰竭住院的组合.
主要成果:
- 6558名患者被随机分组 (3268名伊瓦布拉丁,3290名安慰剂),随访时间中位数为22.9个月.
- 伊瓦布拉丁显著减少了18%的初级终点事件 (HR 0.82,p<0.0001),主要是由于心力衰竭恶化和心力衰竭死亡的住院减少.
- 副作用:症状性胸 (5%艾瓦布拉丁与1%安慰剂) 和视力障碍 (3%艾瓦布拉丁与1%安慰剂) 在艾瓦布拉丁治疗中更频繁.
结论:
- 用伊瓦布拉丁降低心率可以改善心力衰竭患者的临床结果.
- 这项研究强调了心率在心力衰竭病理生理学中的关键作用.
- 伊瓦布拉丁是选择心力衰竭患者的有效治疗选择,以减少不良事件.
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