患有心力衰竭的患者的心律不整 处方多菲提利德或索塔洛尔
Chien-Yu Huang1, Brian R Overholser1,2, Kevin M Sowinski1,2
1Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette and Indianapolis, Indiana, USA.
JACC. Advances
|November 21, 2024
概括
服用多菲提利德或索塔醇的心力衰竭患者 (心力衰竭患者) 面临心室动脉冲动 (VT) 的风险增加,但心脏骤停 (SCA) 的风险没有增加. 这凸显了在服用这些药物的高血压患者中仔细监测心律失常风险的重要性.
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.
- 临床研究 临床研究
背景情况:
- 降低射出率心力衰竭 (HFrEF) 是一种已知的药物诱导心律失常的风险因素.
- 处方抗心律失常药物治疗心力衰竭患者的心律失常风险尚不清楚.
研究的目的:
- 调查HFpEF与心室低心率 (VT) 和心脏骤停 (SCA) 风险之间的关联.
- 为了确定多费提利德或索塔醇的使用是否会增加HFpEF患者的静脉瘤和SCA风险.
主要方法:
- 对医疗保险索赔和药房数据 (2014-2016) 的回顾性分析.
- 包括患有HFrEF,HFpEF和没有HF的患者,使用dofetilide/sotalol和非用户.
- 倾向性得分匹配和一般化的Cox比例危险建模来评估VT和SCA风险.
主要成果:
- 在HFrEF (HR:7.00) 和HFpEF (HR:1.99) 患者中,整体静脉瘤风险显著增加.
- 多菲提利德/索塔醇的使用与HFpEF (HR: 2.34) 和HFrEF患者的静脉瘤风险增加有关.
- 在HFrEF和HFpEF中,整体SCA风险升高,但多菲提利德/索塔醇的使用并没有显著增加SCA风险.
结论:
- 服用 HFpEF 处方多菲提利德或索塔醇的患者患静脉瘤的风险增加.
- 在HFpEF患者中使用多费提利德/索塔醇时,SCA的风险没有显著增加.
- 这些发现强调了需要仔细考虑HFpEF患者使用抗心律不良药的必要性.
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