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在接受非心脏手术的患者中Ivabradine:随机对照试验
Wojciech Szczeklik1, Jakub Fronczek1, Zbigniew Putowski1
1Centre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland.
Circulation
|August 30, 2025
概括
在非心脏手术 (MINS) 后,伊瓦布拉丁没有减少心肌损伤. 这种选择性心率降低剂在一项试验中进行了测试,该试验因徒劳而提前停止,对MINS预防没有任何好处.
科学领域:
- 心脏病学
- 麻醉学
- 药理学
背景情况:
- 在外科手术期间的β阻塞会降低心率,但会增加低血压和中风等风险.
- 选择性心率降低剂伊瓦布拉丁作为预防非心脏手术后心肌损伤的潜在替代品进行了研究.
研究的目的:
- 评估艾瓦布拉丁在非心脏手术 (MINS) 后预防心肌损伤的疗效.
主要方法:
- 一项多中心,双盲,安慰剂对照试验,涉及2101名患有或有动脉样硬化疾病风险的45岁以上患者.
- 患者在非心脏手术前接受口服伊瓦布拉丁或安慰剂治疗长达7天.
- 主要结局是30天内出现MINS.
主要成果:
- 在艾瓦布拉丁组中,MINS发生在17. 0%的患者中,而在安慰剂组中为15. 1% (RR,1. 12;95% CI,0. 92-1.37;p=0. 25).
- 试验因无效而提前停止, 有条件的功率为6%.
- 伊瓦布拉丁显著降低了手术期间的心率,但没有影响平均动脉压.
结论:
- 伊瓦布拉丁没有降低非心脏手术 (MINS) 后心肌损伤的发生率.
- 这项研究表明,伊瓦布拉丁在该患者群体中无法有效预防MINS.
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