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JACC:急性心肌梗死患者早期醛固酮受体拮抗剂治疗未见任何益处

2016-04-20 崔倩 译 MedSci原创

盐皮质激素受体拮抗剂(MRA)可改善心肌梗死(MI)后心脏衰竭(HF)的结果。这项研究旨在评估在急性心肌梗死(不论是否存在HF或左心室(LV)功能障碍)患者中早期MRA方案的好处。研究人员随机分配1603例患者接受标准治疗加单次静脉注射坎利酸钾(200毫克)的MRA治疗方案,其次是口服安体舒通(25毫克,每天一次)治疗6个月,或接受单独标准治疗。该研究的主要终点是死亡,心脏骤停复苏,显著室性心律失

盐皮质激素受体拮抗剂(MRA)可改善心肌梗死(MI)后心脏衰竭(HF)的结果。

这项研究旨在评估在急性心肌梗死(不论是否存在HF或左心室(LV)功能障碍)患者中早期MRA方案的好处。

研究人员随机分配1603例患者接受标准治疗加单次静脉注射坎利酸钾(200毫克)的MRA治疗方案,其次是口服安体舒通(25毫克,每天一次)治疗6个月,或接受单独标准治疗。该研究的主要终点是死亡,心脏骤停复苏,显著室性心律失常,需要植入式除颤器,或者在随访6个月时发生HF或恶化的复合终点。关键次要/安全终点是6个月时包括死亡和其他主要终点的组成部分以及高钾血症患病率。

治疗组和对照组分别有95(11.8%)和98(12.2%)例患者发生主要结果(危险比[HR]:0.97; 95%可信区间(CI):0.73〜1.28)。治疗组和对照组分别有11(1.4%)和17(2.1%)例患者死亡(HR:0.65; 95%CI:0.30〜1.38)。在非预先指定的探索性分析中,ST段抬高心肌梗死亚组(n=1229)的治疗组中死亡几率降低(3[0.5%] vs 15[2.4%];HR 0.20;95%CI 0.06至0.70),但在非ST段抬高心肌梗死患者中却没有减少(相互作用p=0.01)。在治疗组和对照组分别有3%和0.2%患者的高血钾>5.5 mmol/L(P<0.0001)。

该研究未能显示出在入院的MI患者的标准治疗早期加入MBA有任何益处。

原始出处:

Farzin Beygui,Guillaume Cayla,Vincent Roule,et al.Early Aldosterone Blockade in Acute Myocardial Infarction,JACC,2016.4.19

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    2016-10-22 hbwxf
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    2016-05-01 lshanp

    那螺内酯应该在急性心肌梗死后何时应用才能获益呢?

    0

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    2016-04-26 jjzouyan

    不见益处

    0

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    2016-04-24 黑心天使

    额?对于有心衰的指南不是推荐的吗?

    0

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    2016-04-22 cmsvly
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