在接受β-阻塞剂的HFrEF患者中停止使用digoxin:这对未来心力衰竭的"敲门试验"具有影响
Phillip H Lam1, Kevin Liu2, Amiya A Ahmed3
1Veterans Affairs Medical Center, Washington, DC; Georgetown University, Washington, DC; Medstar Washington Hospital Center, Washington, DC.
The American journal of medicine
|October 18, 2024
概括
在已经服用β阻塞剂的心力衰竭患者中,停止治疗心力衰竭与减少排气分数 (HFrEF) 是安全的. 这项研究没有发现HFrEF患者死亡或再入院的风险增加,当他们停止服用贝塔抑制剂时停止使用狄戈辛时.
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.
背景情况:
- 目前的心力衰竭指南建议为心力衰竭与减少喷射率 (HFrEF) 进行四重治疗.
- 指导方针对停止使用老年心力衰竭药物的益处不确定,其清晰度较低.
- 这项研究调查了在接受β-阻断剂的HFrEF患者中停止迪戈辛的安全性.
研究的目的:
- 为了确定停用狄戈辛是否对接受β-阻断剂的HFrEF患者安全.
- 评估在服用β抑制剂的HFrEF患者中消毒素停止治疗和不良结果之间的关联.
主要方法:
- 在OPTIMIZE-HF研究中,分析了2477名患者的HFrEF (EF ≤45%),这些患者服用β阻塞剂和狄戈辛.
- 一个由433对的倾向性得分匹配的队列被创建用于迪戈辛继续治疗与停止治疗组.
- 估计了1年结果的危险比率,包括心力衰竭再入院和死亡.
主要成果:
- 在接受β阻塞剂的患者中,断药时与联合心力衰竭再入院或死亡没有显著的关联 (HR,1.01;95% CI,0.85-1.19).
- 没有观察到心力衰竭再入院 (HR,1.03;95% CI,0.85-1.25) 或死亡 (HR,0.91;95% CI,0.72-1.14) 的显著增加.
- 相比之下,在未服用β抑制剂的患者中,断掉狄戈辛与这些结果的风险增加有关.
结论:
- 在同时接受β-阻断剂治疗的HFrEF患者中,可以安全地停止使用digoxin.
- 需要进一步的研究来评估老年心力衰竭药物的剩余益处,以确保安全停药.
- 在指导方针导向的医疗治疗中,优化HFrEF患者的药物治疗方案至关重要.
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