对慢性心力衰竭与减少喷射小部分管理的国际指导方针的比较
1Clinical pharmacy resident, Abu Dhabi Health Services Company (SEHA); Department of Pharmacology & Therapeutics, United Arab Emirates University (UAEU).
Current problems in cardiology
|June 11, 2023
概括
降低射出率心力衰竭 (HFrEF) 治疗指南在全球范围内有所不同,影响了疾病负担. 需要采取统一的国际努力,改善HFrEF管理,降低患者和医疗保健成本.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 心力衰竭 (HF) 是一种重要的心血管疾病 (CVD),导致全球死亡率,并给患者和医疗保健系统带来巨大的负担.
- 有效的治疗策略对于降低HF死亡率,发病率和相关成本至关重要.
- 近年来,高心力衰竭治疗指南不断更新,特别是在心力衰竭与减少喷射率 (HFrEF) 的治疗指南中.
研究的目的:
- 分析和比较来自中国,加拿大,欧洲,葡萄牙,俄罗斯和美国的最新HFrEF管理指南.
- 调查HFrEF治疗建议的差异与由此产生的疾病负担 (包括死亡率,发病率和成本) 之间的关联.
- 强调在HFrEF准则制定方面需要全球合作.
主要方法:
- 进行了广泛的文献搜索,从选定的国家提取最新的HFrEF管理指南建议.
- 分析了治疗建议,包括使用 ангиотензинII受体阻断剂加上 neprilysin 抑制剂 (ARNI),β 阻断剂 (BB),矿物质皮质素受体对抗剂 (MRA) 和/葡萄糖共传递-2 抑制剂 (SGLT2i).
- 疾病负担的变化 (流行率,发病率,死亡率和年度成本) 在各国之间进行了评估.
主要成果:
- 各个国家在HFrEF管理指南和相关疾病负担中观察到显著的差异.
- 俄罗斯的年成本最低,但患病率和发病率最高.
- 美国和欧洲在患病率,发病率或年度成本方面没有显著差异,而全球5年HF死亡率在50%至70%之间.
结论:
- 高度环境环境环境管理指南的差异导致全球疾病负担变化.
- 统一的全球协作方法对于提高HFrEF管理准则至关重要.
- 改进指南将有助于降低HFrEF对全球患者和医疗保健系统的负担.
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