相关实验视频
β-阻断剂的使用和在稳定的门诊患者和没有冠状动脉疾病的临床结果
Sripal Bangalore1, Gabriel Steg, Prakash Deedwania
1Cardiovascular Clinical Research Center, New York University School of Medicine, 550 First Ave, New York, NY 10016, USA. sripalbangalore@gmail.com
JAMA
|October 4, 2012
概括
在患有冠状动脉疾病 (CAD) 或风险因素的患者中,β阻塞剂的使用没有显著减少心血管事件,除了最近的心肌梗塞 (MI). 这项研究质疑其超出标准后心脏病治疗的好处.
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.
- 流行病学 流行病学
背景情况:
- 贝塔抑制剂是心肌梗塞 (MI) 后的标准护理.
- 它们对患有冠状动脉疾病 (CAD) 且没有心脏病发作,远程心脏病发作史或仅有CAD风险因素的患者的益处尚不确定.
研究的目的:
- 评估β-阻断剂使用与心血管事件之间的关联在稳定患者之前的MI,没有MI的CAD,或只有CAD风险因素.
主要方法:
- 从REACH注册表中对44708名患者进行了长度观察研究.
- 患者被分为三个队列:先前的MI,没有MI的CAD,只有CAD风险因素.
- 倾向性得分匹配用于初级分析,随访时间中位数为44个月.
主要成果:
- 在所有队列中,使用β阻塞剂的复合心血管事件 (死亡,非致命性心脏病发作,中风) 没有显著差异.
- 在没有心脏病发作的心脏病患者中观察到的二次结局 (动脉血事件/再血管化) 的更高率,与使用β-阻断剂的MI队列.
- 在CAD风险因素中发现的主要和次要事件率的增加仅与β-阻断剂使用相对应.
- 使用β-阻断剂与近期心脏病发作 (≤1年) 患者的二次结局发生率较低有关.
结论:
- 在患有CAD风险因素,先前心脏病发作或没有心脏病发作的CAD患者中,β-阻断剂的使用与复合心血管事件的风险降低无关.
- 这些发现表明,在某些稳定的CAD患者群体中,可能需要重新评估β-阻断剂的适用性.
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