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作为心力衰竭治疗的动脉狭窄的重血管化:观察性队列研究
Darren Green1, James P Ritchie1, Constantina Chrysochou2
1Institute of Population Health, University of Manchester, Manchester, UK.
Lancet (London, England)
|August 28, 2015
概括
在心力衰竭患者中,动脉再血管化显著降低了死亡率和住院率. 建议在心力衰竭诊所对这种治疗选择进行进一步的研究.
科学领域:
- 心脏病学
- 肝脏病学
- 血管医学
背景情况:
- 心脏衰竭导致5%的住院病例,4年死亡率超过50%.
- 动脉狭窄影响了54%的心力衰竭患者.
- 对于心力衰竭的治疗效益仍未确立.
研究的目的:
- 在患有心力衰竭和动脉狭窄症的患者中,比较动脉再血管化的临床结果.
- 为了验证心力衰竭的潜在治疗方案.
主要方法:
- 在英国科中心进行前性纵向观察研究.
- 招募了动脉硬化性动脉狭窄症患者 (> 50%).
- 终点包括全因死亡率和心力衰竭住院;生存分析使用了Cox比例危险模型.
主要成果:
- 招募了611名患者 (152名心力衰竭患者),平均年龄为70岁,平均EGFR为33毫升/ 分钟/ 1. 73平方米.
- 在 31% 的心力衰竭患者中进行了再血管.
- 心力衰竭患者的重血管化与全因死亡率显著降低 (HR 0. 6, p=0. 01) 以及心力衰竭入院减少的趋势 (HR 0. 2, p=0. 06).
结论:
- 在心力衰竭中,动脉狭窄的再血管化与死亡率和住院率的显著降低有关.
- 观察数据表明潜在的益处, 需要进行随机试验.
- 建议在心力衰竭诊所加强动脉狭窄的检查.
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