多药对心力衰竭晚期,接受心脏再同步治疗的患者的临床结果的影响
Yuma Ono1, Hidekazu Kondo1, Taisuke Harada1
1Department of Cardiology and Clinical Examination, Faculty of Medicine Oita University Yufu Oita Japan.
Journal of arrhythmia
|January 16, 2025
概括
超多药性,定义为10种或更多种药物,与接受心脏再同步治疗 (CRT) 的心脏衰竭与减少喷射率 (HFrEF) 患者的晚期存活率较差有关. 非心血管药物可能会导致这些负面结果.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 临床药理学 临床药理学
背景情况:
- 心力衰竭 (HF) 和高多药性正在老龄化人口中增加.
- 超多药性对HF结果产生负面影响,但其对接受心脏再同步治疗 (CRT) 的低射率 (HFrEF) 患者的晚期HF的影响尚不清楚.
研究的目的:
- 研究接受CRT的高级HFrEF患者的超多药性和临床结果之间的关联.
- 确定导致不良结果的特定药物类型.
主要方法:
- 对147名接受CRT (2004-2020) 的高级HFrEF患者进行了回顾性分析.
- 患者分为非多药性 (<5),多药性 (≥5),非高多药性 (<10) 和高多药性 (≥10) 组.
- 卡普兰-梅尔对主要心血管不良事件 (MACE) 和全因死亡率的生存分析.
主要成果:
- 超多药性 (≥10种药物) 与MACE的长期存活率明显差 (p=0.004) 和所有原因死亡率 (p=0.005) 相关.
- 在仅考虑心血管药物时,在多药和非多药组之间没有观察到显著的生存差异.
- 涉及非心血管药物的多药性与非心血管药物的非多药性相比,显著恶化MACE (p=0.006) 和全因死亡率 (p=0.003).
结论:
- 超多药性是接受CRT的高级HFrEF患者不良心血管结果的重要危险因素.
- 过多药物的有害影响可能主要是由非心血管药物驱动的.
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