多药与心力衰竭患者的死亡率之间的关联:来自PULSE数据集的结果

Janine Beezer^1,2, Andrew L Clark³, Adam Todd^2,4

¹South Tyneside and Sunderland Foundation Trust, Sunderland Royal Hospital, Sunderland, UK.

ESC heart failure

|October 11, 2025

概括

多药性,即使用多种药物,与心力衰竭中减少喷射率 (HFrEF) 患者的死亡率增加有关. 然而,在心力衰竭中没有发现这种关联,这些患者有保存的喷射分数 (HFpEF).

科学领域:

心脏病学心脏病学
老年病的医生老年病的医生
药理学药理学是指药理学的学科.

背景情况:

心力衰竭 (HF) 的管理受到高死亡率的挑战,特别是在患有多种并发症和多药的老年患者中.
理解多药对死亡率的影响对于优化HF治疗策略至关重要.

研究的目的:

调查多药与心力衰竭住院患者的死亡率之间的关联.
为了区分多药对心力衰竭与减少喷射率 (HFrEF) 和心力衰竭与保存喷射率 (HFpEF) 亚型之间的死亡率的影响.

主要方法:

一项追溯的纵向观察队列研究,涉及660名心力衰竭患者.
在入院和出院时收集了药物数据,用于首次HF住院.
考克斯的比例危险模型和反向概率加权回归分析被用来评估与死亡率的关联.

主要成果:

近60%的患者在平均随访2.9年期间死亡;没有多药的出院很少 (5%).
与保存喷射分数 (HFpEF) 的心力衰竭相比,与HFrEF相比,死亡风险增加了32%.
在HFrEF中,在单变量分析中,高多药性与死亡率翻倍相关,但在多变量分析中,这一点失去了. 在HFrEF中,平均治疗效果表明高多药性治疗的死亡率更高 (26%的增加).
在HFpEF中,在无变量或平均治疗效果分析中,高多药性与死亡率没有显著关联.

结论:

年龄,性别,查尔森并发症指数 (CCI) 和临床脆弱度量表 (CFS) 是高血压患者死亡率的重要预测因素.
经过严格的混调整后,多药与HFrEF的死亡率有关,但与HFpEF无关.
需要进一步的研究来阐明多药,衰老,并发症和心力衰竭结果中的脆弱性之间的复杂相互作用.

关键词:

心脏衰竭是因为心脏衰竭.死亡率死亡率死亡率结果的结果.多种药房多种药房

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