Eur J Heart Fail：哪些药物可改善射血分数降低的心衰患者的生活质量？

2021-03-29 MedSci原创 MedSci原创

哪些药物可改善射血分数降低的心衰患者的生活质量？

射血分数降低的心力衰竭（HFrEF）会增加死亡和住院风险，影响日常功能和健康相关的生活质量（HRQoL）。当前HFrEF的药物管理主要侧重于序贯采用在随机临床试验中已被证明了的可降低其死亡和住院风险的药物。但这些干预对HRQoL的影响尚未明确。

本研究旨在整合HFrEF药物治疗对患者HRQoL的影响的证据。

2020年6月，Turgeon等人检索了MEDLINE、Embase、Central、CINAHL、ClinicalTrials.gov和世界卫生组织国际临床试验注册平台，纳入了评估当代HFrEF药物治疗的有HRQoL结果数据的随机安慰剂对照试验。主要结果是HRQoL，采用随机效应模型进行随访分析。

总体上，共筛查了5770篇文章，最终纳入了其中37项研究。10个试验的偏倚风险较低，27个试验的偏倚风险较高/不明确。

结果总结

荟萃分析的高确定性证据表明，与安慰剂相比，钠-葡萄糖共转运蛋白2(SGLT2)抑制剂和静脉铁治疗均可改善患者的HRQoL（标准化平均差[SMD]分别为 0.16和0.52）。

此外，来自≥1里程碑式试验的高确定性证据表明，与安慰剂相比，血管紧张素受体阻滞剂（ARB）、伊伐布雷定和硝酸肼都能改善患者的HRQoL（SMD分别是0.09、0.14和0.24）；而且，血管紧张素受体-脑活素抑制剂(ARNI)与血管紧张素转换酶(ACEI)相比，也能改善患者的HRQoL（0.09）。

基于低到中等的确定性证据，ACEI、β-受体阻滞剂、地高辛和口服铁的研究结果尚不能确定。

总之，ARB、ARNI、SGLT2抑制剂、伊伐布雷定、硝酸肼和静脉铁均可改善HFrEF患者的HRQoL。这些发现或有助于患者的治疗决策的制定。

原始出处：

Turgeon Ricky D,Barry Arden R,Hawkins Nathaniel M et al. Pharmacotherapy for heart failure with reduced ejection fraction and health-related quality of life: a systematic review and meta-analysis. Eur J Heart Fail, 2021, https://doi.org/10.1002/ejhf.2141

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2021-03-31 病毒猎手

#射血分数#

0 0
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2021-03-31 zy&kt

谢谢！

64 0
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2021-03-31 zhaojie88

#ART#

23 0
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2021-03-31 yuanming7

#心衰患者#

34 0
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2021-03-31 lmm399

#射血分数降低#

44 0
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2021-03-31 fusion

#射血分数降低的心衰#

39 0
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2021-03-31 slcumt

#HEART#

40 0

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