芬龙,多药,心力衰竭中的临床结果:从FINEARTS-HF试验中预先规定的分析
Yasuhiro Hamatani1,2, Brian L Claggett1, Ian J Kulac1
1Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
European journal of heart failure
|March 2, 2026
概括
在多种药物治疗的患者中,芬瑞能有效治疗心力衰竭,轻微减少或保留射出分数 (HFmrEF/HFpEF). 这种药物在不同的药物计数中表现出一致的心血管益处和安全性.
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.
背景情况:
- 患有轻微减少或保留喷射分数 (HFmrEF/HFpEF) 的心力衰竭患者通常具有多种并发症,需要多种药物治疗.
- 在HFmrEF/HFpEF患者中的多药性可能导致在开始新药时犹.
- 了解不同药物负担的治疗效应对于优化护理至关重要.
研究的目的:
- 根据同时服用的药物的数量,评估芬瑞在HFmrEF/HFpEF患者的疗效和安全性.
- 分析不同类别的非多药,多药和超多药的治疗效应.
主要方法:
- 一个预先规定的分析FINEARTS-HF试验涉及6001名参与者与HFmrEF/HFpEF.
- 基线药物使用被分为非多药性 (≤4),多药性 (5-9),和超多药性 (≥10).
- 主要结局是心血管死亡和总心力衰竭事件的复合,评估跨药物类别.
主要成果:
- 60%的患者有多种药物,31%有多种药物,平均8.4种药物.
- 主要结局的发生率随着药物计数的增加而增加.
- 费内伦在减少心血管死亡和HF事件方面表现出一致的好处,无论基线药物计数 (Pinteraction = 0.94).
- 在所有多种类型的药物中,芬二和安慰剂组之间的严重不良事件和研究药物停药率相似.
结论:
- 在FINEARTS-HF试验中,超过90%的HFmrEF/HFpEF患者表现出多药性或超多药性.
- 这些患者面临心血管事件的风险增加.
- 菲内伦提供了一种安全有效的治疗选择,即使在药物负担很高的患者中,也可以减少心血管死亡和HF事件.
相关概念视频
01:22Heart Failure Drugs: Diuretics
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
01:11Renal Failure: Dose Adjustments
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:29Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
01:30Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
01:22Heart Failure VI: Adjunct Therapies
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.