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射血分数保留的心力衰竭:I-PRESERVE试验中4133例患者的临床特征

Heart failure with preserved ejection fraction: clinical characteristics of 4133 patients enrolled in the I-PRESERVE trial.

作者信息

McMurray John J V, Carson Peter E, Komajda Michel, McKelvie Robert, Zile Michael R, Ptaszynska Agata, Staiger Christoph, Donovan J Mark, Massie Barry M

机构信息

Department of Cardiology, Western Infirmary, Glasgow, and Faculty of Medicine, University of Glasgow, Scotland, UK.

出版信息

Eur J Heart Fail. 2008 Feb;10(2):149-56. doi: 10.1016/j.ejheart.2007.12.010.

Abstract

BACKGROUND

We describe the baseline characteristics of subjects randomised in the largest placebo-controlled, morbidity-mortality trial to date in patients with heart failure and preserved ejection fraction - the irbesartan in heart failure with preserved systolic function trial (I-PRESERVE).

METHODS AND RESULTS

4133 patients with a mean age of 72 years (a third were 75 years or older) were randomised and 60% were women. The mean (SD) LVEF was 59 (9)% and almost 80% of patients were in NYHA Class III or IV. Approximately 80% of patients were also overweight or obese. Heart failure was reported by investigators to have a hypertensive aetiology in 64% of patients. Prior myocardial infarction was relatively uncommon (24%), as was coronary revascularisation (13%). Atrial fibrillation and diabetes each occurred in between a quarter and a third of patients. The following treatments were used at baseline: diuretic 83%, beta-blocker 59%, calcium channel blocker 40%, ACE inhibitor 25%, spironolactone 15% and digoxin 14%.

CONCLUSIONS

Patients in I-PRESERVE are broadly representative of those seen in epidemiological studies and, because of this, the results of this trial should be generally applicable to "real world" patients with heart failure and preserved ejection fraction.

摘要

背景

我们描述了在迄今为止最大规模的针对射血分数保留的心力衰竭患者的安慰剂对照发病率-死亡率试验——心力衰竭收缩功能保留患者中使用厄贝沙坦的试验(I-PRESERVE)中随机分组的受试者的基线特征。

方法与结果

4133例平均年龄72岁(三分之一为75岁及以上)的患者被随机分组,其中60%为女性。左心室射血分数(LVEF)的平均值(标准差)为59(9)%,近80%的患者为纽约心脏协会(NYHA)III级或IV级。约80%的患者超重或肥胖。研究人员报告,64%的患者心力衰竭病因是高血压。既往心肌梗死相对不常见(24%),冠状动脉血运重建也是如此(13%)。四分之一至三分之一的患者发生心房颤动和糖尿病。基线时使用了以下治疗方法:利尿剂83%,β受体阻滞剂59%,钙通道阻滞剂40%,血管紧张素转换酶(ACE)抑制剂25%,螺内酯15%,地高辛14%。

结论

I-PRESERVE试验中的患者广泛代表了流行病学研究中观察到的患者,因此,该试验结果应普遍适用于“现实世界”中射血分数保留的心力衰竭患者。

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