心力衰竭与保存的射出分数,红细胞分布宽度,和萨库比特里尔/瓦尔萨坦
Jawad H Butt1,2, Kirsty McDowell1, Toru Kondo1
1British Heart Foundation Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK.
ESC heart failure
|October 9, 2023
概括
红细胞分布宽度 (RDW) 是心力衰竭与保留射出分数 (HFpEF) 的不良结果的重要预测因素. 萨库比特里尔/瓦尔萨坦疗法在HFpEF患者中显示了RDW水平的适度降低.
科学领域:
- 心脏病学 心脏病学
- 临床生物标志物 临床生物标志物
- 心脏衰竭研究研究
背景情况:
- 红细胞分布宽度 (RDW) 是心力衰竭的已知的预后指标,其排气分数减少.
- 在心力衰竭中,RDW的预后价值与保存的喷射分数 (HFpEF) 仍然不太了解.
- 研究RDW在HFpEF中的作用对于完善风险分层和治疗策略至关重要.
研究的目的:
- 评估RDW在HFpEF患者的预后意义.
- 评估萨库比特里尔/瓦尔萨坦与瓦尔萨坦相比对RDW水平和HFpEF临床结果的影响.
- 为了确定RDW是否会改变HFpEF中sacubitril/valsartan的治疗效果.
主要方法:
- 分析PARAGON-HF试验的数据,包括LVEF≥45%的患者.
- 评估基线RDW四分位数与主要终点 (HF住院或心血管死亡) 之间的关系.
- 萨库比特里尔/瓦尔萨坦和瓦尔萨坦治疗组之间的 RDW 变化和临床结果的比较.
主要成果:
- 较高的基线RDW与初级终点的风险增加有关,这种风险以分级的方式增加,即使在多变量调整后.
- 这种关联在二次结局中持续存在,包括心血管和全因死亡率.
- 在48周后,萨库比特里尔/瓦尔萨坦治疗导致RDW的小但显著减少,与瓦尔萨坦相比.
结论:
- RDW是一种廉价,易于获得的生物标志物,在HFpEF中提供增量预后价值.
- 萨库比特里尔/瓦尔萨坦治疗导致HFpEF患者的RDW水平略有下降.
- RDW水平没有显著改变萨库比特里尔/瓦尔萨坦与瓦尔萨坦的治疗效果.
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