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Yusuke Kobari1, Annette Maznyczka2, Arif A Khokhar1
1The Heart Center, Rigshospitalet, Copenhagen, Denmark.
JACC. Cardiovascular interventions
|January 14, 2026
概括
心力衰竭指南导向医疗疗 (GDMT) 在心力衰竭患者中未得到充分使用,心力衰竭患者的排气分数减少 (HFrEF) 经历过透气管大动脉置换 (TAVR). 在这个人群中,低于最佳的HF-GDMT增加了主要的不良心血管事件 (MACE).
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 医疗疗优化医疗疗优化
背景情况:
- 有限的数据存在于心力衰竭 (HF) 指南导向医疗疗 (GDMT) 影响心力衰竭 (HF) 患者心力衰竭 (HF) 减少喷射分数 (HFrEF) 接受过导管大动脉置换 (TAVR).
- 评估HF-GDMT的坚持及其在TAVR患者的预后价值HFrEF对于改善结果至关重要.
研究的目的:
- 评估HF-GDMT在TAVR患者中最佳使用的HFrEF.
- 为了确定HF-GDMT在这个患者队列中的预后意义.
主要方法:
- 一个潜在的注册表包括TAVR患者的HFrEF,分层由出院时的HF-GDMT处方和3个月的优化.
- 主要不良心血管事件 (MACE) 被定义为心血管死亡率或HF住院治疗.
- 随访时间中位数为699天.
主要成果:
- 只有27%的符合条件的患者在TAVR后3个月接受了四倍的HF-GDMT.
- 两年MACE的发生率在四倍治疗 (15.0%) 与三倍 (22.6%),双倍 (24.2%) 或单次/无治疗 (43.6%) 相比显著较低.
- 观察到最佳HF-GDMT的使用不足,低于最佳的治疗与更高的MACE相关.
结论:
- 在TAVR患者中,HF-GDMT在HFrEF患者中未得到充分利用.
- 在这个人群中,低于最佳的HF-GDMT与MACE的增加有关.
- 对于 HFrEF 的 TAVR 患者来说,需要改进启动和升级 HF-GDMT 的策略.
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