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JACC:β-受体阻滞剂和心率对心衰患者预后的影响!

2017-06-13 MedSci MedSci原创

目前,对于伴有窦性节律或房颤的心衰患者,心率与其死亡率的关系尚未明确。近日,在国际心血管权威杂志JACC上发表了一篇荟萃分析,旨在分析探讨随机对照试验比较β-受体阻滞剂和安慰剂对心力衰竭患者心率的预后重要性。

目前,对于伴有窦性节律或房颤心衰患者,心率与其死亡率的关系尚未明确。近日,在国际心血管权威杂志JACC上发表了一篇荟萃分析,旨在分析探讨随机对照试验比较β-受体阻滞剂和安慰剂对心力衰竭患者心率的预后重要性。

该研究通过对11项双盲随机对照临床试验的患者数据进行荟萃分析,主要终点事件是全因死亡率。对在基线和随机化后6个月测量的心率模型进行Cox比例风险比(HR)分析。结果表明,对于窦性心率的心衰患者,基线的高心率与全因死亡率的升高相关(n = 14166; 调整后HR: 1.11; 95% CI: 1.07-1.15; p <0.0001),而在房颤的心衰患者中不相关(n = 3034; HR: 1.03; 95% CI: 0.97-1.08; p = 0.38)。β-受体阻滞剂可以降低心衰患者的室性心率每分钟12下。在随机接受β-受体阻滞剂治疗的窦性心衰患者中,全因死亡率更低(HR: 0.73 vs安慰剂; 95% CI: 0.67-0.79; p < 0.001),而β-受体阻滞剂对房颤的心衰患者没有明显的作用(HR: 0.96, 95% CI: 0.81-1.12; p = 0.58)。对于窦性心率的心衰患者,较低的静息心率对患者预后有益(HR: 1.16, 95% CI: 1.11-1.22; p < 0.0001)。

无论治疗前的心率如何,β-受体阻滞剂可以降低窦性心率心衰患者的死亡率。较低的静息心率对心衰患者的预后有益,但仅限于窦性心率的患者。

原始出处:

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    2017-08-30 hbwxf
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    2017-06-24 zhyy88
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    2017-06-13 三生有幸9135

    学习一下谢谢分享

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