在慢性稳定心力衰竭的老年患者中停止循环利尿剂:叙述性审查
Chukwuma Okoye1,2, Tessa Mazzarone3, Cristina Cargiolli3
1Geriatrics Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Paradisa, 2, 56124, Pisa, Italy. chukwuma.okoye@phd.unipi.it.
Drugs & aging
|August 24, 2023
概括
停止循环利尿剂 (LDs) 可能对稳定的心力衰竭 (HF) 患者是安全的,可能会降低长期风险. 需要进一步的研究,特别是在老年人中,以确认安全性和有效性.
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.
- 老年病的医生 老年病的医生
背景情况:
- 循环利尿剂 (LDs) 是心力衰竭 (HF) 症状缓解的标准,但可能具有长期不良影响,特别是在老年,脆弱的人群中.
- 较新的HF药物提供了更好的结果和症状管理,促使重新评估LD使用.
- 有限的研究存在于撤回LDs在稳定的HF患者,特别是老年人的安全性.
研究的目的:
- 审查当前关于在慢性稳定心力衰竭患者中停止循环利尿剂的安全性和有效性的证据.
- 在现代高频管理的背景下,评估LD退出的潜在风险和好处.
主要方法:
- 2000年1月至2022年11月间发表的研究的系统综述,来源于PubMed和Scopus.
- 包括两项随机对照试验和其他三项相关研究.
- 专注于患有慢性稳定心力衰竭的患者,主要是那些射出分数减少的患者.
主要成果:
- 停用利尿剂治疗似乎是稳定的HF患者的潜在安全策略.
- 评估的关键结果包括需要重新启动利尿剂,死亡和停药后再住院.
- 证据有限,总体而言,证据的质量较低.
结论:
- 停止循环利尿剂可能是选择慢性稳定心力衰竭患者的可行策略.
- 为了证实这些发现,需要进行进一步的强有力的研究,特别是在老年人群中,考虑到脆弱性.
- 在临床实践中,对于稳定的HF管理来说,LD退出的潜在好处值得考虑.
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