JAMA:RAS抑制剂可改善主动脉瓣置换患者预后

2018-12-10 zhangfan MedSci原创

研究认为,接受经导管主动脉瓣置换术患者出院后进行肾素-血管紧张素系统抑制治疗有助于降低心衰住院及死亡风险

模型研究发现,肾素-血管紧张素系统(Ras)抑制剂可逆转经导管主动脉瓣置换术(TAVR)后左室重构,改善功能。近日研究人员对其临床价值进行了考察。

TAVR后接受RAS治疗的患者参与研究,研究的主要终点为出院一年后,心力衰竭死亡和重新入院。次要终点堪萨斯城心肌病健康评估(KCCQ,0-100,分数越高,健康程度越高)。

21312名TAVR患者参与研究,其中39.7%接受出院后RAS抑制剂治疗。参与者平均年龄82.4岁,女性占48.1%,平均LVEF为51.9%。1年后,接受RAS治疗人群的死亡率(12.5% vs 14.9%)和心衰住院率(12.0% vs 13.8%)更低。保留LVEF人群,接受RAS治疗后,死亡风险进一步降低(11.1% vs 13.9%),但对于未保留人群则不显著(18.8% vs 19.5%)。RAS治疗人群KCCQ得分较高,但差异不显著。

研究认为,接受经导管主动脉瓣置换术患者出院后进行肾素-血管紧张素系统抑制治疗有助于降低心衰住院及死亡风险。

链接:堪萨斯城心肌病调查问卷(KCCQ-23问卷)

原始出处:


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    2019-02-24 jklm09
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    2019-02-20 yxch48
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