达帕格利弗洛辛在心力衰竭中具有轻微减少或保留的喷射分数根据多药房状态
Alexander Peikert1, Parag Goyal2, Muthiah Vaduganathan1
1Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
JACC. Heart failure
|June 9, 2023
概括
达帕格利弗洛辛有效地减少了心力衰竭恶化或心血管死亡的患者保存喷射分数,即使那些使用多种药物. 该药物在不同级别的多药中表现出一致的安全性和有效性.
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:
- 心力衰竭 (HF) 患者经常有多种并发症,导致多药.
- 在多药患者中引入新药可能会引起临床关注.
研究的目的:
- 评估达帕格利弗洛辛在心力衰竭患者中具有轻微减少或保留射出分数的疗效和安全性,特别是根据同时服用药物的数量分析其性能.
- 确定达帕格利弗洛辛的益处是否在不同水平的药物使用中是一致的,包括非多药,多药和超多药.
主要方法:
- 对Deliver试验的后期分析,涉及6,263名参与者,症状为HF和左心室喷射分数>40%,随机分配给达帕格利弗洛辛或安慰剂.
- 根据基线药物使用情况,参与者被分为非多药 (<5种药物),多药 (5-9种药物) 和高多药 (≥10种药物) 组.
- 疗效 (主要结局:恶化HF或心血管死亡) 和安全结果被评估在这些药物使用类别和连续.
主要成果:
- 较高的药物计数与增加的并发症负担和初级结局率相关.
- 与安慰剂相比,达帕格利弗洛辛始终降低了初级结局风险,无论多药状态 (Pinteraction = 0.30) 和整个药物使用范围 (Pinteraction = 0.06).
- 不良事件增加了更多的药物,但不管多药房状态如何,都没有更多的达帕格利弗洛辛.
结论:
- 达帕格利弗洛辛 (Dapagliflozin) 提供了一种安全有效的治疗选择,可以减少心力衰竭恶化或心血管死亡的患者,即使是那些服用多种药物的患者,也保留了喷射分数.
- 达帕格利弗洛辛的益处在广泛的基线药物使用中是一致的,包括多药和高多药患者.
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