在有结构性心脏病的心律失常患者中使用flecainide
Naruepat Sangpornsuk1,2,3,4, Voravut Rungpradubvong5,2,3, Tachawut Tiensantisuk1,2,3
1Section of Electrophysiology, Division of Cardiovascular Medicine, Department of Medicine, Chulalongkorn University, Bangkok, Thailand.
Therapeutic advances in drug safety
|February 13, 2025
概括
在结构性心脏病患者中使用弗莱卡因并没有增加心室节律失常或死亡率. 这项研究表明,除了缺血性心脏病之外,flekainide可能对某些结构性心脏病是安全的.
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.
- 电子生理学 电子生理学
背景情况:
- 目前的指导方针限制了flekainide在患有正常或最小结构性心脏病的患者的使用.
- 在CAST研究中,在心肌梗塞后的患者中,长期使用flekainide的死亡率增加,排泄分数减少.
- 然而,随后的研究表明,在其他结构性心脏病中是安全的.
研究的目的:
- 为了研究心脏结构性疾病的患者与没有心脏结构性疾病的患者,在用弗莱卡尼尼德治疗时,心脏动 (VT) 或心脏动 (VF) 的发生率.
- 为了评估flecainide在不同程度的结构性心脏病患者群体中的安全性.
主要方法:
- 对447名在过去5年中至少服用过一剂弗莱卡尼尼德的患者进行了回顾性研究.
- 包括336名患者,将他们分为结构性心脏病 (47名患者) 和非结构性心脏病组.
- 评估了基线特征,弗莱卡尼德的指示,心声学,并评估了1年后的心室节律失常和全因死亡率.
主要成果:
- 在结构性心脏病组的4.7%和非结构性心脏病组的1.1%中发生了心室心律不整.
- 在结构性心脏病和心室心律不整的发病率增加之间没有发现统计学意义上的关联 (OR = 4.8,p = 0.139).
- 在结构性心脏组中经历心律失常的患者之前有心律失常史.
结论:
- 在这个队列中,使用弗莱卡因并没有导致心室节律失常或死亡率增加的结构性心脏病患者.
- 这些发现表明,除了缺血性心脏病之外,在结构性心脏病中,flekainide的潜在安全性.
- 建议进行进一步的前性研究,以确认 flecainide 在特定非缺血性结构性心脏病中的安全性.
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