稳定冠状动脉疾病中的β阻塞剂:观察性研究的系统审查和元分析
Jing-Xuan Liu1, Shi-Yue Zheng1, Fei Guo1
1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China.
Reviews in cardiovascular medicine
|January 12, 2026
概括
在稳定的冠状动脉疾病患者中,β-阻断剂治疗没有显著的心血管益处,患者的左心室功能被保留. 这一元分析支持对这些患者进行个性化风险评估而不是常规处方.
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.
- 临床研究 临床研究
背景情况:
- 在稳定的冠状动脉疾病 (CAD) 中,β阻塞剂的作用与左心室功能的保存是有争议的.
- 现有证据不足以指导这种特定患者群体的治疗.
研究的目的:
- 进行全面的元分析,评估β-阻断剂治疗的心血管相关性.
- 评估β-阻断剂在稳定的CAD患者中有效性的评估,其左心室喷射分数 (> 50%) 保存.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 包括9项观察性研究,涉及超过90万名患者.
- 主要结局:心脏病死亡;次要结局:所有原因的死亡率,心脏病发作,中风,心力衰竭.
主要成果:
- 贝塔抑制剂治疗与心脏病死亡没有显著的关联 (HR 0.98,95% CI:0.93-1.04).
- 对于所有原因的死亡率,心脏病发作,中风或心力衰竭,没有发现显著的关联.
- 观察到所有死因 (I2 = 87%) 和心力衰竭 (I2 = 95%) 的高异质性.
结论:
- 在稳定的CAD患者中,β-阻断剂治疗没有显著的心血管益处,其左心室功能被保留.
- 这些发现支持当前的AHA/ACC和ESC指导方针建议在这个人群中使用β抑制剂.
- 个人风险-益处评估是比常规的β-阻断剂处方建议的.
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