开始使用他类药物用于心力衰竭的初级预防,使用保存的喷射分数
Ariela R Orkaby1,2,3, Parag Goyal4, Brian Charest2
1New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA.
JACC. Advances
|June 28, 2024
概括
在没有先前动脉样硬化心血管疾病 (ASCVD) 的退伍军人中,他类药物显著降低了死亡率和主要不良心血管事件 (MACE). 这一发现支持在这个患者群体中使用他类药物.
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.
- 公共卫生 公共卫生
背景情况:
- 陈列药物已被证明是动脉样硬化心血管疾病 (ASCVD) 和死亡率的首要预防.
- 有限的数据存在于没有ASCVD的心脏衰竭与保存喷射分数 (HFpEF) 患者的他类药物的益处.
研究的目的:
- 调查 HFpEF 患者的他类药物使用与降低死亡风险和主要心血管不良事件 (MACE) 之间的关联.
- 评估他类药物对该特定人群住院率的影响.
主要方法:
- 利用了与医疗保险/医疗补助和药物记录相关的退伍军人卫生管理局数据 (2002-2016).
- 包括新诊断的HFpEF患者,没有先前的ASCVD或他类药物的使用.
- 使用Cox比例危险模型和倾向得分重叠权重 (PSW) 进行分析.
主要成果:
- 在7970名退伍军人中,47%的人开始服用他类药物;PSW后的特征平衡.
- 达丁类药物使用者对所有原因死亡的风险降低了22% (HR:0.78).
- 立方体使用与降低MACE (HR:0.79),全因住院 (HR:0.69) 和高压住院 (HR:0.72) 相关.
结论:
- 新的他类药物启动与死亡率,MACE和住院病例的显著减少有关.
- 研究结果支持在老兵中使用他类药物,这些老兵有HFpEF并且没有流行ASCVD.
- 这项研究解决了了解HFpEF中他类药物的疗效的关键差距.
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