基线功能障碍对心力衰竭住院治疗后口服利尿剂疗效的影响 - - TRANSFORM-HF的见解
Pieter Martens1,2, Stephen J Greene3, Robert J Mentz3
1Department of Cardiology, Ziekenhuis Oost-Limburg A.V., Genk, Belgium.
European journal of heart failure
|April 1, 2024
概括
在住院治疗后,Torsemide和furosemide在心力衰竭 (HF) 患者中显示出类似的结果,无论功能如何. 这项研究发现,这两种利尿剂在HF管理中的死亡率,住院病例或生活质量之间没有显著差异.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
背景情况:
- 住院后的心力衰竭 (HF) 管理涉及尿液选择.
- 在患有功能障碍的患者中,由于药理动力学特性,Torsemide通常优先于furosemide,但临床证据有限.
- 在TRANSFORM-HF试验中,对HF患者的torsemide和furosemide策略进行了比较.
研究的目的:
- 为了研究基线功能对托塞米德与弗罗塞米德在心力衰竭住院患者的疗效的影响.
- 为了评估治疗对死亡率,住院和患者报告的结果的影响,在不同的估计球膜过率 (eGFR) 水平上进行评估.
主要方法:
- 对TRANSFORM-HF试验的后期分析,该试验涉及2859名因HF住院的患者.
- 患者根据基线eGFR进行分类:<30,30-<60和≥60毫升/分钟/1.73米2.
- 分析了torsemide与furosemide对所有原因死亡率,所有原因住院和堪萨斯城心肌病问卷临床总结得分 (KCCQ-CSS) 的治疗效应,并对eGFR进行了明确和连续的评估.
主要成果:
- 基线功能 (eGFR) 并没有显著改变torsemide与furosemide对死亡率和住院结果的治疗效果 (p-相互作用>0.108).
- 对于KCCQ-CSS (p-相互作用>0.052) 的变化,没有观察到eGFR对治疗效果的显著改变.
- 这些发现是正确的,不管eGFR是否被分类或连续评估.
结论:
- 在因心力衰竭住院后出院的患者中,torsemide和furosemide的临床结果和患者报告结果相似.
- 在这种患者群体中,torsemide和furosemide之间的选择似乎不受基线功能的影响.
- 这些结果提供了证据,以指导尿剂选择在HF管理中,无论功能如何.
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