-葡萄糖共运输体2 抑制剂在美国门诊心血管保健中用于心力衰竭
Abdelghani El Rafei1, Kensey Gosch2, Evan S Manning3
1Division of Cardiology, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora.
JAMA cardiology
|July 9, 2025
概括
在心力衰竭 (HF) 患者中,-葡萄糖携带载体2抑制剂 (SGLT2i) 的使用增加,但大多数符合条件的患者没有接受这种治疗. 年龄较大,女性性别和高血压与较低的SGLT2i使用有关,并指出了显著的实践差异.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- -葡萄糖共传输体2抑制剂 (SGLT2i) 已被证明可以减少心力衰竭 (HF) 事件和心血管死亡率.
- 美国心血管门诊护理机构对HF患者的SGLT2i利用的当前趋势没有得到充分的记录.
研究的目的:
- 确定在门诊心血管保健机构中诊断为心力衰竭的患者中SGLT2i处方的比率.
- 分析与该人口中SGLT2i使用相关的趋势和因素.
主要方法:
- 使用来自国家心血管数据注册 (NCDR) 实践创新和临床卓越 (PINNACLE) 注册表的数据进行回顾性队列研究.
- 分析包括从2019年7月到2023年6月的191个美国地点的759,000多名患有HF的患者.
- 检查了患者级和实践级SGLT2i处方数据.
主要成果:
- 在高血压患者中,SGLT2i的整体使用率从2019年第三季度的4.6%增加到2023年第二季度的16.2%.
- 与轻微减少或保留喷射率 (HFmrEF/HFpEF) 的HF患者相比,减少喷射率 (HFrEF) 的HF患者中SGLT2i的使用率更高.
- 与使用量较低相关的因素包括年龄,女性性别和较高的静脉压,而2型糖尿病与使用量较高有关. 观察到SGLT2i使用中的实践差异很大.
结论:
- 尽管SGLT2i在心力衰竭患者中的使用增加,但相当一部分符合条件的患者仍然没有接受治疗.
- 低于最佳的使用与患者的人口统计和临床因素有关,以及医疗保健实践中显著的不明原因变化.
- 有针对性的干预措施是必要的,以改善SGLT2i治疗在门诊HF护理中的采用.
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