在接受心脏康复治疗的心力衰竭患者中,指南导向的医学疗法
Claire H Chang1, Tanima Basu2, Scott L Hummel2,3
1Department of Medicine, University of California, San Francisco, San Francisco, California (Chang).
Journal of cardiopulmonary rehabilitation and prevention
|February 2, 2026
概括
针对心力衰竭的指导指导医学疗法 (GDMT) 与减少喷射率 (HFrEF) 在心脏康复 (CR) 中仍未得到充分利用. 药物优化得分没有改善,这表明在CR期间需要更好的GDMT处方策略.
科学领域:
- 心脏病学 心脏病学
- 临床药房 临床药房
- 公共卫生 公共卫生
背景情况:
- 心脏康复 (CR) 为心力衰竭患者提供了一个关键机会,以优化心力衰竭患者的指导指导医学疗法 (GDMT).
- 了解CR中的当前GDMT处方模式对于确定需要改进的领域至关重要.
研究的目的:
- 描述心脏康复计划中HFrEF患者使用GDMT的情况.
- 评估药物优化得分 (MOS) 从CR开始到结束的变化.
主要方法:
- 一个学术医疗中心对电子健康记录的回顾性分析确定了152名在2016年至2023年期间参加CR的HFrEF患者.
- 药物优化得分 (MOS) 在初始和最终的CR会议上使用经过验证的算法计算.
- 威尔科克森签名等级分析用于比较CR之前和之后的MOS.
主要成果:
- 总共分析了172个CR周期. 在CR结束时,只有49%的患者在服用β-阻断剂,49%的患者在服用氨酸- ангиотензин- 阿尔多斯特抑制剂.
- 尽管有84%的患者有资格接受GDMT启动或升级,但中位数MOS仍然低于最佳,从CR开始 (39%) 到CR结束 (35%) 没有显著变化 (P = .90).
结论:
- 在CR中对HFrEF患者的GDMT处方是次优的.
- 在心脏康复计划期间,有很大的未满足的需求和机会来开发和实施战略,以提高GDMT优化.
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