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Circulation:Vericiguat对射血分数降低心衰患者血红蛋白和临床结局的影响

2021-08-29 网络 网络

Vericiguat治疗后贫血很常见,较低的血红蛋白与较高的临床事件发生频率相关。尽管Vericiguat治疗16周时血红蛋白适度降低,但这种效果没有进一步发展。

Vericiguat是一款口服可溶性鸟苷酸环化酶(sGC)调节剂,主要用于治疗恶性慢性心力衰竭和左心室射血分数 (LVEF)降低的患者。在VICTORIA试验中,与安慰剂(5.7%)相比,接受Vericiguat治疗的患者(7.6%)更常发生贫血。

近日,血管领域权威杂志Circulation上发表了一篇研究文章,研究人员旨在探讨Vericiguat、随机化血红蛋白、贫血之间的关联,以及Vericiguat的益处是否与基线血红蛋白相关。


贫血定义为男性血红蛋白<13.0g/dL,女性<12.0g/dL(世界卫生组织[WHO]贫血标准)。研究人员评估了报告为贫血的不良事件(AE),且评估了血红蛋白和血细胞比容与主要结局(心血管死亡或心力衰竭住院的复合结局)之间的风险调整的关联,以及时间更新的血红蛋白与结局的关系。


基线时,1719名(35.7%)患者伴有贫血;中位血红蛋白为13.4g/L(第25、第75个百分位为:12.1和14.7g/dL)。在随机分组后的第16周,1643名患者仍伴有贫血(Vericiguat为284名新患者,安慰剂为219名),与安慰剂相比,Vericiguat更常发生这种情况(p<0.001)。16周后,到96周的随访期间血红蛋白没有进一步下降,血红蛋白/血细胞比容的比率保持不变。总体而言,342名患者(7.1%)发生了贫血AE。较低的血红蛋白与Vericiguat(与安慰剂相比)对主要结果的治疗益处无关。此外,对时间更新血红蛋白的分析显示,Vericiguat(对比安慰剂)与主要结局的疗效没有关联。
 
由此可见,Vericiguat治疗后贫血很常见,较低的血红蛋白与较高的临床事件发生频率相关。尽管Vericiguat治疗16周时血红蛋白适度降低,但这种效果没有进一步发展,也​与Vericiguat的治疗益处无关。

原始出处:

Justin A. Ezekowitz,et al.Hemoglobin and Clinical Outcomes in the VerICiguaT Global Study in Patients With Heart Failure and Reduced Ejection Fraction (VICTORIA).Circulation. 2021.https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.056797

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