奈西立肽治疗心力衰竭的观察单位治疗：来自前瞻性试验的结果。

Observation unit treatment of heart failure with nesiritide: results from the proaction trial.

作者信息

Peacock W F, Holland R, Gyarmathy R, Dunbar L, Klapholz M, Horton D P, de Lissovoy G, Emerman C L

机构信息

Department of Emergency, The Cleveland Clinic, Cleveland, Ohio 44195, USA.

出版信息

J Emerg Med. 2005 Oct;29(3):243-52. doi: 10.1016/j.jemermed.2005.01.024.

DOI:10.1016/j.jemermed.2005.01.024

PMID:16183441

Abstract

This was a multicenter, randomized, double-blind, placebo-controlled pilot study, evaluating the safety and efficacy of a standard care treatment regimen with the addition of either nesiritide or placebo (SCP) in 237 Emergency Department (ED)/Observation Unit (OU) patients with decompensated heart failure (HF). Efficacy measures included initial admission, length of hospital stay (LOS), and inpatient rehospitalization through 30 days. Compared to the standard care group, patients who also received nesiritide had 11% fewer inpatient hospital admissions at the index ED visit (55% SCP, 49% nesiritide, p = 0.436), and 57% fewer inpatient hospitalizations within 30 days after discharge from the index hospitalization (23% SCP, 10% nesiritide, p = 0.058). The duration of rehospitalization was shorter for nesiritide patients (median LOS 2.5 vs. 6.5 days, p = 0.032). The incidence of symptomatic hypotension was low and did not differ between the groups. This study showed that nesiritide is safe when used in the emergency department, observation units, or similar settings.

摘要

这是一项多中心、随机、双盲、安慰剂对照的试验性研究，评估在237例失代偿性心力衰竭（HF）的急诊科（ED）/观察病房（OU）患者中，在标准护理治疗方案基础上加用奈西立肽或安慰剂（SCP）的安全性和有效性。疗效指标包括首次入院情况、住院时间（LOS）以及30天内的住院再入院情况。与标准护理组相比，同时接受奈西立肽治疗的患者在首次ED就诊时的住院入院率降低了11%（SCP组为55%，奈西立肽组为49%，p = 0.436），且在首次住院出院后30天内的住院再入院率降低了57%（SCP组为23%，奈西立肽组为10%，p = 0.058）。奈西立肽治疗的患者再住院时间较短（中位LOS为2.5天对6.5天，p = 0.032）。症状性低血压的发生率较低，且两组之间无差异。本研究表明，奈西立肽在急诊科、观察病房或类似环境中使用时是安全的。