最新的药物方法跨越了心力衰竭的频谱
Dimitrios Bismpos1,2, Jan Wintrich3, Julian Hövelmann3
1Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital, Saarland University, Homburg, Saar, Germany. dimbismp@gmail.com.
Heart failure reviews
|February 13, 2024
概括
对心力衰竭 (HF) 患者而言,指南导向的医疗治疗至关重要,即使有并发症. 最近的数据支持在高频谱中扩大使用SGLT2抑制剂等疗法.
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 (HF) 继续导致显著的发病率和死亡率,特别是在老年人和脆弱的人群中.
- 尽管有进展,但最佳的高压管理需要遵守指导方针,即使有诸如慢性病或低血压等复杂因素.
研究的目的:
- 强调指南导向医学治疗 (GDMT) 在心力衰竭的全谱中的重要性.
- 突出最近的证据支持扩大治疗选择和需要在特定的高频子组进行进一步研究.
主要方法:
- 审查目前的指导方针和最近的临床试验数据.
- 对患有并发症和不同排泄分数的患者治疗效益的分析.
- 考虑新兴的药物疗法和支持性治疗.
主要成果:
- 包括矿物质皮质类受体对抗剂 (MRA),血管新生素受体-尼普利辛抑制剂 (ARNI),SGLT2抑制剂 (SGLT2i) 和β-抑制剂在内的GDMT,显示效益延伸到65%的LVEF.
- -葡萄糖共运输体-2 抑制剂 (SGLT2i) 现在用于保留喷射分数 (HFpEF) 的HF,得到 DELIVER 和 EMPEROR 保存等试验的支持.
- 在HF管理中,越来越多地推静脉注射铁补充剂.
结论:
- 对所有HF患者来说,全面的,基于指南的治疗是必不可少的,平衡风险和益处.
- 需要进一步的试验来完善GDMT对心力衰竭的中等射出分数 (HFmrEF) 和HFpEF.
- 像芬瑞诺这样的新药对未来的HF治疗策略有前途.
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