Eur J Heart Fail:达格列净对射血分数降低的心衰患者贫血的影响

2021-03-26 Nebula MedSci原创

达格列净是否有助于改善心力衰竭患者的贫血症状?

贫血在心力衰竭(HF)患者中很常见,其病因非常复杂,可能反映了肾功能不全、炎症、铁缺乏和使用血管紧张素转换酶抑制剂等治疗。与没有贫血的患者相比,合并贫血的心衰患者通常具有更差的症状、更明显的功能障碍、更高的入院率和较短的生存期。

Docherty等在DAPA‐HF试验中分析了达格列净对纠正射血分数降低的HF患者贫血的效果,还根据基线时的贫血状况分析了达格列净对患者预后的影响。

贫血定义为,在基线时男性红细胞压积<39%,女性<36%。在随访期间任何时候连续两次测量红细胞压积超过上述阈值时即为贫血纠正成功。主要结果是HF恶化(住院或紧急就诊需静脉治疗)或心血管死亡。

在DAPA-HF试验的4744名患者中,4691名患者有基线红细胞压积数据,其中1032名患者合并贫血(22.0%)。

达格列净对有无贫血HF患者心血管预后的影响

贫血患者的主要结局发生率(16.1/100人年)高于非贫血患者(12.9/100人年)。达格列净组62.2%的患者的贫血得到了纠正,而安慰剂组的这一比例仅有41.1%

达格列净对患者红细胞压积的影响

与非贫血患者相比,达格列净对主要预后的影响是一致的[危险比(HR)0.6 8,95%CI 0.52~0.88 vs HR 0.76,95%CI 0.65~0.89;交互作用P=0.44]。在心血管死亡、HF住院和全因死亡方面也观察到了类似的结果。贫血纠正成功的患者的预后比持续贫血状态的患者的更好。

总之,在DAPA-HF试验中,合并贫血的HF患者的预后较差。与安慰剂相比,达格列净治疗增加了患者的贫血纠正率,并改善了患者预后,且与基线时的贫血状态无关。

原始出处:

Docherty Kieran F,Curtain James P,Anand Inder S et al. Effect of dapagliflozin on anaemia in DAPA-HF. Eur J Heart Fail, 2021, https://doi.org/10.1002/ejhf.2132

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    2021-03-31 1436749007

    学到了很多东西谢谢老师

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    2021-03-27 1436749007

    学到了很多,谢谢老师

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    2021-03-28 1436749007

    学到了很多东西谢谢老师

    1

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    2021-03-29 1479ea96m27暂无昵称

    学习

    0

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    2021-03-28 zhaojie88
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    2021-03-28 slcumt
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    2021-03-27 周翠翠

    很详细

    0

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