在癌症诊断之前和之后使用心力衰竭医学治疗:一项纵向研究
Chengsheng Ju1, Wallis C Y Lau1,2,3,4, Charlotte Manisty5,6
1Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
ESC heart failure
|July 23, 2024
概括
心力衰竭患者的癌症诊断导致减少使用指南导向医学疗法 (GDMT),影响坚持和坚持. 这种基本心力衰竭治疗的下降与住院治疗和死亡率的增加有关.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 以指导方针为导向的医学疗法 (GDMT) 对于管理心力衰竭与减少喷射率 (HFrEF) 至关重要.
- 癌症诊断可以显著影响患者的护理和治疗,如HFrEF.同时存在的条件的坚持治疗.
研究的目的:
- 为了评估在癌症诊断前和之后在HFrEF患者中关键GDMTs (RASIs,β-阻断剂,MRAs) 的利用和剂量的变化.
- 将癌症患者的治疗模式与没有癌症的匹配HFrEF患者进行比较.
主要方法:
- 使用英国临床实践研究数据链接 (2005-2021) 进行的纵向研究.
- 根据诊断和处方记录识别了HFrEF患者.
- 将癌症患者 (n=4890) 与非癌症对照组 (n=4890) 相匹配,并使用逻辑回归分析了GDMT的坚持,持续性,启动和剂量定位.
主要成果:
- 在癌症诊断后,HFrEF患者的GDMT使用量和剂量减少.
- 与对照人群相比,癌症患者对RASIs,β-阻断剂和MRA的坚持和坚持不佳的风险显著更高.
- 在癌症患者中观察到RASI和β-阻断剂剂剂量降低定位的风险增加.
- 对GDMT的不良坚持或持久性与更高的HF住院率和死亡率有关.
结论:
- 癌症诊断与使用和遵守HFrEF的GDMTs的显著下降有关.
- 这种减少HFrEF癌症患者的基于证据的治疗可能会导致不良的临床结果,包括住院治疗和死亡率.
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