在儿科心力衰竭中Sacubitril-valsartan与ACE/ARB对比:一个回顾性队列研究
Zachariah E Hale1, Laura Prichett2, Simran Jandu3
1Division of Pediatric Cardiology, Johns Hopkins University, Baltimore, Maryland.
概括
与ACE抑制剂/ARB相比,萨库比特利-瓦尔萨坦在儿科心力衰竭患者中没有显著降低死亡率或心脏移植率. 然而,它与降低血压的增加和减少住院治疗的趋势有关.
科学领域:
- 心脏病学 心脏病学
- 儿科心力衰竭 儿科心力衰竭
- 药理学 药理学是指药理学的学科.
背景情况:
- 萨库比特里尔-瓦尔萨坦是一种新型的血管激素受体/内普利辛抑制剂,已被批准用于儿科心力衰竭.
- 像PANORAMA-HF这样的现有试验在儿科患者的纳入方面存在局限性.
- 进一步的研究是必要的,以了解sacubitril-valsartan在儿童群体中的作用.
研究的目的:
- 为了比较在一年内因任何原因死亡或心脏移植的发病率,在接受sacubitril-valsartan和服用ACE抑制剂 (ACE) 或血管新生素II受体抑制剂 (ARB) 的儿科患者之间.
主要方法:
- 一项使用TrinetX数据库的回顾性队列研究.
- 倾向性得分匹配用于比较519名接受萨库比特里尔-瓦尔沙坦治疗的患者与519名接受ACE/ARB治疗的匹配对照.
- 主要综合结局是全因死亡率或一年内心脏移植.
主要成果:
- 在sacubitril-valsartan和ACE/ARB组 (13.3%对13.2%,p=0.95) 之间没有观察到死亡率或心脏移植综合结果的显著差异.
- 低血压的发生率在萨库比特里尔-瓦尔萨坦组 (10%对5.2%,p=0.006) 显着更高.
- 萨库比特里尔-瓦尔萨坦 (1.3对2.0,p=0.09) 患者每年住院治疗减少的趋势.
结论:
- 在这个儿科队列中,萨库比特里尔-瓦尔萨坦并没有显著降低1年死亡率或心脏移植率.
- 未来的研究应该专注于优化剂量以减轻低血压,并进一步评估其减少住院治疗的潜力.
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