■对于心力衰竭(HF)的患者,建议使用舒必曲/缬沙坦(SV)。此外,4种HF药物的组合,包括SV,建议用于射血分数降低(HFrEF)的HF患者。然而,关于能够延续SV的患者的特征及其起始方法的证据有限.
■调查与SV延续相关的因素以及合并HF药物的方法。
这项回顾性队列研究包括在我们机构接受SV治疗的HF患者。终点是SV开始后持续6个月。多因素分析用于提取与SV延续相关的因素。联合HF药物(肾素-血管紧张素系统抑制剂,β受体阻滞剂,盐皮质激素受体拮抗剂,或钠-葡萄糖协同转运蛋白2抑制剂),包括HF药物的数量,他们的组合模式,以及他们入会的时机,在HFrEF患者中检查SV继续。
■在186名符合条件的患者中,68.8%有HFrEF,79.0%的SV持续6个月。与SV延续相关的重要因素是白蛋白≥3.5g/dL(比值比,4.81;95%置信区间,2.19-10.59),体重指数(BMI)≥18.5kg/m2(4.17;1.10-15.85),收缩压(SBP)≥110mmHg(2.66;1.12-6.28)。在HFrEF患者中,未与SV同时启动的HF药物的比例在继续组中显著高于停药组(67.3%vs33.3%,P=0.002)。HF药物的数量及其组合模式与SV的延续没有显着相关。
■白蛋白,BMI,和SBP是选择可能继续SV的患者的有用指标.此外,在HFrEF患者中,仅使用SV而不同时使用其他HF药物可能导致SV继续治疗.
UNASSIGNED: Sacubitril/valsartan (SV) is recommended for patients with heart failure (HF). In addition, a combination of 4 HF medications, including SV, is recommended in patients with HF with reduced ejection fraction (HFrEF). However, evidence on the characteristics of patients who could continue SV and its initiation methods is limited.
UNASSIGNED: To investigate the factors associated with SV continuation and methods of combining HF medications.
UNASSIGNED: This retrospective cohort study included HF patients who initiated with SV at our institution. The endpoint was SV continuation for 6 months after its initiation. Multivariate analysis was used to extract factors associated with SV continuation. The relationship between the methods of combining HF medications (renin-angiotensin system inhibitors, beta-blockers, mineralocorticoid receptor antagonists, or sodium-glucose cotransporter 2 inhibitors), including the number of HF medications, their combination patterns, and the timing of their initiation, and SV continuation was examined in patients with HFrEF.
UNASSIGNED: Of 186 eligible patients, 68.8% had HFrEF, and 79.0% continued SV for 6 months. Significant factors associated with SV continuation were albumin ≥ 3.5 g/dL (odds ratio, 4.81; 95% confidence interval, 2.19-10.59), body mass index (BMI) ≥ 18.5 kg/m2 (4.17; 1.10-15.85), and systolic blood pressure (SBP) ≥ 110 mmHg (2.66; 1.12-6.28). In patients with HFrEF, the proportion of HF medications not initiated simultaneously with SV was significantly higher in the continuation group than in the discontinuation group (67.3% vs 33.3%, P = 0.002). The number of HF medications and their combination patterns were not significantly associated with SV continuation.
UNASSIGNED: Albumin, BMI, and SBP are useful indicators for selecting patients who are likely to continue SV. In addition, initiating only SV without simultaneously initiating other HF medications in patients with HFrEF may lead to SV continuation.