在为大动脉狭窄而进行大动脉置换手术后,宁-血管激素系统的抑制
Andreas Martinsson1,2, Charlotta Törngren2,3, Susanne J Nielsen2,3
1Department of Cardiology, Sahlgrenska University Hospital, Goteborg, Sweden andreas.s.martinsson@vgregion.se.
Heart (British Cardiac Society)
|July 17, 2023
概括
雷宁-血管素系统 (RAS) 抑制剂显著减少了主要的不良心血管事件 (MACE) 和外科上风门置换 (SAVR) 后的全因死亡. 这种疗法为接受主动脉狭窄的SAVR治疗的患者提供了改善的结果.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 外科手术的结果
背景情况:
- 对于大动脉狭窄的SAVR后最佳医疗治疗还没有得到很好的定义.
- 氨酶系统 (RAS) 抑制剂可能会增强心脏重塑和SAVR后患者的结果.
研究的目的:
- 调查RAS抑制剂与SAVR后患者的临床结果之间的关联.
- 为了比较RAS抑制剂与没有RAS抑制剂在减少主要心血管不良事件 (MACE) 的疗效.
主要方法:
- 在瑞典 (2006-2020年) 对11894名接受主动脉狭窄治疗的SAVR患者进行了回顾性队列研究.
- 主要结局:MACE (所有原因死亡率,中风,心肌梗塞).
- 用于分析RAS抑制剂使用的时间更新的Cox回归模型,与子组和ACE抑制剂/ARB比较.
主要成果:
- RAS抑制与13%较低的MACE风险 (aHR 0.87) 和21%较低的全因死亡风险 (aHR 0.79) 相关.
- 除了机械假肢患者之外,各个子组的益处一致.
- 无论是ACE抑制剂还是ARB,都显示了MACE的风险降低.
结论:
- 在SAVR后的RAS抑制剂治疗与显著降低MACE和全因死亡率有关.
- 这些发现支持使用RAS抑制剂作为治疗主动脉狭窄的SAVR后医疗管理的一部分.
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