由于心力衰竭而住院治疗后,氨酸-血管素系统抑制剂的减少
Parag Goyal1, Ligong Chen2, Jennifer D Lau1
1Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
ESC heart failure
|July 20, 2024
概括
在心力衰竭住院治疗后,在老年人中降低宁-血管素系统抑制剂 (RASI) 剂量并没有使结果恶化. 降低剂量是一种更安全的替代品,而不是在需要RASI调整时停止治疗.
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.
- 老年病的医生 老年病的医生
背景情况:
- 减少喷射分数 (HFrEF) 的心力衰竭管理通常涉及氨酸-血管新生素系统抑制剂 (RASI).
- 在老年人中,医院住院后对HFrEF进行RASI剂量调整的数据有限.
- 了解RASI在住院后的处方模式对于优化患者护理至关重要.
研究的目的:
- 评估RASI剂量减少与停药在住院后HFrEF的老年人中的疗效.
- 评估RASI处方模式与死亡率和再接收率的关联.
主要方法:
- 对因HFrEF住院的医疗保险受益人的回顾性分析.
- 将患者分为相同/增加RASI剂量,减少剂量或停止治疗的组.
- 考克斯比例危险模型用于检查30天和1年的结果.
主要成果:
- 36.8%的患者有RASI剂量减少 (15.7%的剂量减少,21.1%的停止).
- 无论是减少RASI剂量还是停止使用都与30天死亡率无关.
- 停止RASI治疗,但没有减少剂量,与1年死亡率和再入院率的增加有关.
结论:
- 在HFrEF住院后,减少RASI剂量是一种常见的做法.
- 减少RASI剂量与短期或长期不良结果无关.
- 减少RASI剂量是最好的策略,而不是在RASI调整必要时停止治疗.
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