在非ST升高急性冠状动脉综合征患者的β-阻塞剂的不良影响阻塞性睡眠呼吸暂停患者
Zekun Zhang1, Siyi Li1, Ge Wang1
1Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
Sleep medicine
|May 22, 2025
概括
β抑制剂可能会增加非ST升高急性冠状动脉综合征 (NSTE-ACS) 患有阻塞性睡眠呼吸暂停 (OSA) 的患者的不良心血管事件. 这一发现突出了与这种特定患者群体的标准NSTE-ACS治疗相关的潜在风险.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 药理学 药理学是指药理学的学科.
背景情况:
- β抑制剂是非ST升高急性冠状动脉综合征 (NSTE-ACS) 的标准治疗方法.
- 在NSTE-ACS患有阻塞性睡眠呼吸暂停 (OSA) 的患者中使用β阻塞剂的研究有限.
研究的目的:
- 评估贝塔阻断剂和心血管结局在NSTE-ACS患者和没有OSA之间的关联.
主要方法:
- 对前性观察性OSA-ACS项目的部分分析 (NCT03362385).
- 包括1452名NSTE-ACS患者携带便携式睡眠监测数据.
- 主要终点:主要不良心血管事件 (MACE).
主要成果:
- 在OSA (77.4%) 和非OSA (73.2%) 组中,释放时使用β-阻断剂的情况类似.
- 在OSA组中,比不使用者而言,β阻塞剂使用者具有显著更高的MACE风险 (调整后HR1.90).
- 在OSA患者的这种风险增加在倾向性得分匹配 (调整后的HR 2.18) 后仍然存在.
结论:
- 贝塔抑制剂的使用与NSTE-ACS患者患有OSA的不良心血管结果增加有关.
- 目前的β-阻断剂建议可能需要重新评估NSTE-ACS患者的OSA.
相关概念视频
Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
1.0K
β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
1.0K
Heart Failure Drugs: β-Blockers
446
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
446
Sleep Apnea
227
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
227
Antihypertensive Drugs: Types of β-Blockers
916
β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and...
916
Antianginal Drugs: Nitrates and β-Blockers
772
In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow....
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow....
772
Adrenergic Antagonists: ɑ and β-Receptor Blockers
650
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is...
650


