对心力衰竭的现代医学疗法跨射出分数光谱:OPTIPHARM-HF注册表
Riccardo M Inciardi1,2,3, Maurizio Volterrani4, Gianluigi Savarese2
1Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
European journal of heart failure
|December 18, 2025
概括
对心力衰竭 (HF) 的指导指导医学疗法 (GDMT) 仍未得到充分利用,但近年来,在EF频谱中,HFrEF和SGLT2抑制剂的四倍疗法越来越多.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 建议针对心力衰竭 (HF) 进行指南导向医学治疗 (GDMT),但仍未充分利用和剂量不足.
- 本研究解决了理解GDMT在整个射出分数 (EF) 的全谱实施方面的差距.
研究的目的:
- 评估当前使用,剂量和GDMT的实施在当代,全国范围的HF成年患者队列中.
- 评估患者减少 (HFrEF),轻度减少 (HFmrEF) 和保存 (HFpEF) 喷射分数的GDMT模式.
主要方法:
- 一项前性,多中心的观察性研究 (OPTIPHARM-HF,NCT06192524) 涉及意大利32个HF中心的3054名患者.
- 评估临床特征和医疗治疗在第一次诊断前后的患病率.
- 根据EF分层分析:HFrEF (≤40%),HFmrEF (40-49%) 和HFpEF (≥50%).
主要成果:
- 在HFrEF中,对β抑制剂的处方率很高 (90%),但对ACEi/ARB (19%) 的处方率较低,ARNI (61%),MRA (72%) 和SGLT2i (69%) 显示适度使用. 不到60%的人达到目标剂量,47%的人接受了四倍治疗.
- 在第一次访问后,所有药物类别的处方增加了,64%的患者获得了四重治疗 (p < 0.001).
- 在HFmrEF和HFpEF中,SGLT2抑制剂的使用在第一次访问后显著增加 (分别达到74%和54%,p <0.001).
结论:
- 在心力衰竭患者中,GDMT的使用在整个射出分数谱中仍然不足.
- 近年来,在HFrEF中,四倍GDMT的采用越来越多.
- 在HFmrEF和HFpEF队列中观察到SGLT2抑制剂处方的显著增加.
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