迪戈辛使用对持续流动左心室辅助器件患者的胃肠道出血的影响:系统性审查和元分析
Matteo Marchetti1, Barbara Pitta Gros1, Olivier Muller1
1From the Division of Cardiology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.
概括
在患有连续流动左心室辅助器件 (CF-LVADs) 的患者中,迪戈辛可能会减少胃肠道出血. 这项元分析发现,在CF-LVAD患者中,狄戈辛的使用与血管扩张相关出血的风险较低有关.
科学领域:
- 心脏病学 心脏病学
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 持续流动的左心室辅助装置 (CF-LVADs) 改善了晚期心力衰竭的结果,但增加了胃肠道出血 (GIB) 的风险.
- 减少CF-LVADs中的脉动性流动可能会导致粘膜缺氧,促进血管扩张和GIB的形成.
- 迪戈辛在抑制缺氧诱导因子 (HIF) - 1α方面的潜力表明,它可能会预防胃肠道血管张症 (GIAD).
研究的目的:
- 评估在CF-LVADs患者中使用狄戈辛和GIB发生之间的关联.
- 为了确定狄戈辛是否会影响该患者群体中与GIAD相关的GIB发病率.
主要方法:
- 进行了一项元分析,包括四项研究,涉及14917名患者 (2742名受益于狄戈辛,12175名未受益于狄戈辛).
- 研究比较了使用狄戈辛与未使用狄戈辛的成年CF-LVAD接受者的GIB发生率 (主要结果).
- 数据包括患者人口统计,CF-LVAD类型 (轴向与离心) 和GIB结果.
主要成果:
- 迪戈辛的使用显示出非显著的趋势,导致整体GIB风险降低 (HR:0.70;95%CI:0.49-1.01).
- 迪戈辛的使用与与GIAD相关的GIB风险较低显著相关 (HR:0.33;95% CI:0.13-0.82).
- 分析包括一个大队列,其中78%接受了轴向CF-LVAD,22%接受了离心装置.
结论:
- 在CF-LVAD患者中使用digoxin与降低整体GIB的趋势有关.
- 在患有CF-LVADs的患者中,迪戈辛显著降低了与GIAD相关的GIB风险.
- 进一步的研究可能会澄清狄戈辛在CF-LVAD接受者的GIB并发症管理中的作用.
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