循环利尿剂处方对死亡率和心力衰竭再入院的比较影响
Arti V Virkud1, Patricia P Chang1, Michele Jonsson Funk2
1School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
The American journal of cardiology
|November 16, 2023
概括
托尔塞米德可能会降低心力衰竭 (HF) 患者的死亡率和再入院率,与罗塞米德相比. 布梅坦尼德在这个循环利尿剂有效性的现实世界研究中没有与罗塞米德显著的差异.
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.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 循环利尿剂对于心力衰竭 (HF) 管理至关重要.
- 富洛塞米德是常见的处方,但托塞米德和布梅坦尼德提供了潜在的优势,如优越的生物可用性.
- 有限的现实世界数据存在,比较了这三种循环利尿剂的结果.
研究的目的:
- 为了比较furosemide,torsemide和bumetanide在治疗心力衰竭方面的有效性.
- 评估在出院时选择循环利尿剂对死亡率和心力衰竭再入院的影响.
- 分析与在住院后启动不同循环利尿剂相关的现实世界结果.
主要方法:
- 对2007-2017年医疗保险索赔数据的回顾性分析.
- 包括在心脏衰竭指数住院后开始使用furosemide,torsemide或bumetanide的患者.
- 使用治疗权重的逆概率来调整混因素并估计6个月的风险.
主要成果:
- 这项研究包括62,632个富洛塞米德,1,720个托塞米德和2,389个布梅坦尼德启动剂.
- 托塞米德与最低的6个月调整后所有原因死亡风险 (13.2%) 和复合结局风险 (21.4%) 相关.
- 与furosemide相比,torsemide显示出较低的死亡率和明显较低的综合结局风险的趋势.
结论:
- 在心力衰竭住院后,在出院时处方的循环利尿剂的选择与患者患病率的显著差异有关.
- 在这个老年患者群体中,torsemide似乎与比furosemide更好的结果有关.
- 虽然趋势表明潜在的好处,但可能需要进一步的研究来确认所有结果的统计学意义.
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