多药对心力衰竭患者3年死亡率的影响:一项回顾性研究
Daisuke Hayashi1, Yoshiaki Kubota2, Takuya Nishino3
1Department of Pharmaceutical Service, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
Journal of pharmaceutical health care and sciences
|July 3, 2024
概括
心力衰竭患者的多药性与死亡率有关,但并非所有药物都有同等的贡献. 减少非指南导向药物 (ni-GDMT) 可能改善心力衰竭预后.
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.
- 临床医学 临床医学
背景情况:
- 在心力衰竭管理中,指南导向医学治疗 (GDMT) 是至关重要的.
- 多药性,即使用多种药物,可能会对心力衰竭的结果产生负面影响.
- 管理多药的策略,特别是哪些药物要逐渐减少,需要进一步研究.
研究的目的:
- 研究心力衰竭患者处方GDMT药物数量与预后之间的关系.
- 为了确定非指导药物 (ni-GDMT) 的数量是否会影响心力衰竭的结果.
主要方法:
- 一项回顾性研究包括3,146名心力衰竭患者.
- 根据出院时的GDMT和ni-GDMT药物的数量,患者被分组.
- 主要结局是出院后3年内全因死亡率.
主要成果:
- 在3年内,共有252人死亡.
- 较高的ni-GDMT药物计数与所有原因死亡率的增加显著相关 (HR=1.06,P=0.020).
- GDMT药物计数没有显示与死亡率增加的关联.
结论:
- 非指导药物 (ni-GDMT) 的数量是心力衰竭3年死亡率的重要预测指标.
- 指南导向医学疗法 (GDMT) 药物计数与更差的预后无关.
- 多药店的管理策略应侧重于减少ni-GDMT,以改善心力衰竭患者的治疗结果.
更多相关视频
相关概念视频
Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
57
Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
57
Heart Failure Drugs: Diuretics
362
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
362
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
419
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
419
Drug Therapy
41
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
41
Pathophysiology of Heart Failure
1.5K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.5K
Heart Failure Drugs: β-Blockers
336
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
336


