在心力衰竭和轻度减少和保存的喷射分数患者中,β-阻塞剂的使用和结果
Shingo Matsumoto1,2, Alasdair D Henderson1, Li Shen1,3
1British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
European journal of heart failure
|August 31, 2024
概括
在心力衰竭中使用β阻塞剂,保持或轻微减少喷射分数 (HFpEF/HFmrEF) 并没有与更糟糕的结果相关. 这项观察性研究发现了调整后的益处,特别是在心房的患者中.
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.
- 临床试验 临床试验
背景情况:
- 保存喷射率 (HFpEF) 和轻微减少喷射率 (HFmrEF) 的心力衰竭代表着不同的患者群体.
- 随机试验证据在HFpEF/HFmrEF中的β-阻断剂 (BB) 疗效是有限的.
- 观测数据可以提供关于这些高频子类型的BB使用的见解.
研究的目的:
- 调查β-阻断剂 (BB) 使用与HFpEF和HFmrEF患者的临床结果之间的关联.
- 在没有直接随机试验证据的情况下,分析这些高频群体中BBs的结果.
主要方法:
- 从四个大型HF试验 (I-Preserve,TOPCAT,PARAGON-HF,DELIVER) 的个人患者数据进行了汇总.
- 包括16,951名患者,平均LVEF为56.8%,其中79.1%具有HFpEF (LVEF≥50%).
- 比较BB用户 (75.6%) 和非用户之间的结果,调整预后变量.
主要成果:
- 主要结局是心血管死亡或HF住院治疗的组合.
- 调整后的分析显示,BB使用者与非使用者之间的主要结局的风险较低 (aHR 0.81,95% CI 0.74-0.88).
- 观察到与心房的显著相互作用,在这个子组中使用BB显示出更好的结果 (p=0.02).
结论:
- 观察分析表明,在HFmrEF/HFpEF中,接受β-阻断剂治疗的结果没有更差.
- 对预后变量进行了广泛的调整,没有发现不良关联.
- 使用β-阻断剂可能会带来好处,特别是在心房的HF患者中.
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