滴红素使用与急性冠状动脉综合征后的长期死亡率之间的关联
Onni Erkkilä1, Jussi Hernesniemi2, Juho Tynkkynen3
1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
The American journal of cardiology
|August 13, 2023
概括
在急性冠状动脉综合征 (ACS) 患者中使用digoxin与死亡率的增加有关. 这项研究发现,在接受狄戈辛治疗的ACS患者中,死亡率更高,即使在调整了风险因素后.
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.
- 临床研究 临床研究
背景情况:
- 迪戈辛是一种用于心房动和心力衰竭的药物.
- 之前关于狄戈辛和死亡率的研究产生了相互矛盾的结果.
- 急性冠状动脉综合征 (ACS) 患者是药物效应至关重要的脆弱人群.
研究的目的:
- 评估急性冠状动脉综合征 (ACS) 患者的狄戈辛使用与全因死亡率之间的关联.
- 为了澄清关于狄戈辛对心血管病患者死亡率的影响的相互矛盾的发现.
- 在ACS管理的背景下调查狄戈辛的安全性.
主要方法:
- 在2007年至2017年期间接受治疗的8388名ACS患者的回顾性分析.
- 利用综合健康数据和医生维护的临床表型在线数据库.
- 雇员调整了考克斯回归模型和治疗权重的逆概率 (IPTW) 来分析死亡率的关联.
主要成果:
- 在ACS患者中,4.0%的患者在住院期间接受了狄戈辛.
- 在考克斯回归模型 (调整HR1.23) 中,滴红素治疗与全因死亡率的增加有关.
- 对治疗权重的反向概率 (IPTW) 分析也表明狄戈辛与死亡率增加之间存在显著的关联 (ATE HR 1.71,TT HR 1.32).
结论:
- 在急性冠状动脉综合征 (ACS) 期间的迪戈辛治疗与任何原因死亡的风险更高有关.
- 即使调整多个风险因素并考虑选择偏差后,这种关联仍然存在.
- 研究结果表明,由于潜在的不良后果,在给ACS患者开迪戈辛时应谨慎使用.
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