萨库比特里尔/瓦尔萨坦和心力衰竭的认知结果,减少了喷射分数
Prabhjot K Grewal1, Alan Abboud2, Evangelos Pavlos Myserlis3
1Department of Medicine, Stony Brook University, Stony Brook, New York, USA.
JACC. Advances
|June 28, 2024
概括
与ACE抑制剂/ARB相比,在心力衰竭患者中使用萨库比特里尔/瓦尔萨坦与减少射出分数 (HFrEF) 有关,认知能力下降,痴呆和阿尔茨海默病的风险降低了31%.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 最近的数据表明,用萨库比特里尔抑制 neprilysin 可能有利于心力衰竭和射出小部分>40%的患者.
- 关于普里利辛抑制的神经认知目标外影响的担忧在很大程度上被驳斥了.
- 这项研究研究了萨库比特里尔/瓦尔萨坦对心力衰竭和减少喷射率 (HFrEF) 患者认知结果的影响.
研究的目的:
- 为了比较HFrEF患者用sacubitril/valsartan治疗的3年认知结果与传统的 ангиотензин转化酶抑制剂 (ACEI) 或 ангиотензин受体阻断剂 (ARB) 相比.
主要方法:
- 一项回顾性队列研究包括11,313名在sacubitril/valsartan开始的HFrEF成年人和11,313名在ACEI/ARB.的倾向匹配的患者.
- 数据来源于41个美国医疗保健组织的TrinetX研究网络.
- 主要终点包括认知衰退,痴呆症和阿尔茨海默病的复合体,评估时间为3年.
主要成果:
- 接受萨库比特里尔/瓦尔沙坦治疗的患者在3年后表现出主要终点的发生率显著降低 (10.7%vs15.0%;HR:0.69;P<0.001).
- 在sacubitril/valsartan组中观察到较低的认知衰退 (9.5%对13.3%),痴呆 (3.4%对5.0%) 和阿尔茨海默病 (0.6%对1.3%) 的比率.
- 在萨库比特里尔/瓦尔萨坦队列中,三年死亡率也降低了 (22.0%对24.6%;HR:0.89;P<0.001).
结论:
- 萨库比特里尔/瓦尔萨坦治疗与HFrEF患者在3年内神经认知障碍的显著减少有关.
- 这些发现表明,萨库比特里尔/瓦尔萨坦在这个患者群体中具有潜在的神经保护益处.
- 这项研究支持使用sacubitril/valsartan来管理HFrEF,与ACEI/ARB相比可能增加认知优势.
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