在心力衰竭患者中,矿物质皮质类药物对手的使用不足,心脏衰竭患者的排泄分数减少
Shingo Matsumoto1, Toru Kondo1, Pardeep S Jhund1
1British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, United Kingdom.
Journal of the American College of Cardiology
|August 29, 2023
概括
像eplerenone这样的矿物质皮质类受体对抗剂,无论疾病持续时间如何,都有利于心力衰竭患者的心力衰竭和减少喷射率 (HFrEF). 埃普勒诺的绝对益处在患有较长时间的HFrEF的患者中最大.
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:
- 心力衰竭与减少喷射分数 (HFrEF) 持续时间对矿物质皮质类受体抗剂的有效性和安全性的影响尚不清楚.
- 矿物质皮质类受体抗剂对于管理HFrEF至关重要,但它们的有效性可能因患者患有这种疾病的时间而异.
研究的目的:
- 调查eplerenone在HFrEF患者的安全性和有效性,根据心力衰竭的持续时间分层.
- 为了确定eplerenone的好处是否在不同的HFrEF持续时间组之间有所不同.
主要方法:
- 分析了EMPHASIS-HF试验数据,根据HFrEF持续时间将患者分为三组:少于1年,1至少于5年,5年或以上.
- 主要结局,心力衰竭住院或心血管死亡的组合,在调整预后变量后使用考克斯回归模型进行评估.
主要成果:
- 患有较长HFrEF持续时间的患者年龄较大,并患有更多的并发症. 主要结果事件发生率随着HFrEF持续时间的增加而增加.
- 在所有HFrEF持续时间组中,eplerenone表现出一致的益处,主要结果的危险比率在每个类别中都显示出有效性.
- 以治疗所需数量表示的eplerenone的绝对益处在HFrEF持续时间最长 (≥5年) 的患者中最为明显.
结论:
- 尽管HFrEF患者的发病率更高,临床状况更差,但eplerenone提供了一致的治疗益处.
- 在减少心血管事件和住院治疗方面,eplerenone的疗效无论心力衰竭的持续时间如何,都保持不变.
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