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在心力衰竭患者住院治疗中,左心室喷射分数和治疗特征之间的关系 - - 一个日本数据库分析
Ichiro Umemura1, Shunsuke Eguchi1, Yohei Morita1
1Medical Affairs Division, Novartis Pharma K.K. Tokyo Japan.
Circulation reports
|October 11, 2023
概括
在日本,心力衰竭 (HF) 的三重组合疗法与减少的喷射分数未得到充分利用. 在老年患者和患有功能障碍的患者中不太常用,但在特定的LVEF亚组中,它显著降低了HF再住院风险.
科学领域:
- 心脏病学 心脏病学
- 药物治疗 药物治疗
- 医疗保健服务研究 医疗服务研究
背景情况:
- 对于心力衰竭 (HF) 建议使用三重组合疗法 (氨酸-动脉酶系统调节剂,β阻断剂,矿物质皮质类受体对抗剂) 以减少射出分数.
- 在日本,医院出院时对其处方率的数据有限.
研究的目的:
- 评估日本因HF住院的患者在医院出院时三重组合治疗的处方率.
- 确定与其不足利用相关的因素.
- 根据左心室喷射率 (LVEF) 评估三重组合疗法与HF再住院风险之间的关联.
主要方法:
- 对3582名因HF住院的日本患者的匿名索赔和电子健康记录数据的回顾性分析.
- 基于LVEF的子组分析.
- 统计分析以确定与治疗使用相关的因素及其对再住院的影响.
主要成果:
- 在所有LVEF亚组中,出院时三重组合治疗处方率很低,从12.5% (LVEF≥60%) 到40.4% (LVEF<30%).
- 高龄,较低的B型尿素水平和功能障碍与较低的处方率有关.
- 在LVEF<50%的患者中,使用三重组合疗法与1年内HF再入院的风险显著降低.
结论:
- 在日本患者中,三重组合疗法在出院时因HF住院的患者显著不足.
- 尽管使用量不足,但其使用与LVEF减少的患者中HF再入院的风险降低有关.
- 需要制定改善指导方针医疗治疗的策略.
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