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2008年欧洲心脏病学会会议临床试验最新进展:TIME-CHF、BACH、BEAUTIFUL、GISSI-HF及HOME-HF

Clinical trials update from European Society of Cardiology meeting 2008: TIME-CHF, BACH, BEAUTIFUL, GISSI-HF, and HOME-HF.

作者信息

Coletta Alison P, Cullington Damien, Clark Andrew L, Cleland John G F

机构信息

Department of Cardiology, University of Hull, Castle Hill Hospital, Cottingham, Kingston-upon-Hull, HU16 5JQ, UK.

出版信息

Eur J Heart Fail. 2008 Dec;10(12):1264-7. doi: 10.1016/j.ejheart.2008.10.002. Epub 2008 Nov 12.

Abstract

This article provides information and a commentary on trials relevant to the pathophysiology, prevention and treatment of heart failure presented at the European Society of Cardiology meeting which was held in Munich, Germany from 30th August to 3rd September 2008. Unpublished reports should be considered as preliminary, as analyses may change in the final publication. The TIME-CHF study failed to show that BNP guided therapy was superior to usual care in patients with heart failure. The BACH study suggested that a new biomarker, MR-proANP, was as good as BNP for the diagnosis of heart failure in patients presenting with breathlessness. Ivabradine failed to reduce the incidence of cardiovascular events in patients with coronary artery disease and left ventricular systolic dysfunction in the BEAUTIFUL study, but patients with higher heart rates might have benefited. In GISSI-HF, n-3 PUFA reduced mortality and cardiovascular hospitalisation by a small amount compared to placebo in patients with chronic heart failure, but rosuvastatin had no effect on clinical outcomes. In the HOME-HF study, telemonitoring support failed to reduce the time to first re-hospitalisation or death, or days alive and out of hospital, compared with usual care.

摘要

本文提供了在2008年8月30日至9月3日于德国慕尼黑举行的欧洲心脏病学会会议上所展示的与心力衰竭的病理生理学、预防及治疗相关试验的信息及评论。未发表的报告应被视为初步报告,因为分析可能会在最终发表时发生变化。TIME-CHF研究未能表明,在心力衰竭患者中,脑钠肽(BNP)指导的治疗优于常规治疗。BACH研究表明,一种新的生物标志物——中段心房利钠肽前体(MR-proANP),在诊断出现呼吸困难的心力衰竭患者时与BNP的效果相当。在BEAUTIFUL研究中,伊伐布雷定未能降低冠心病合并左心室收缩功能不全患者的心血管事件发生率,但心率较高的患者可能从中获益。在GISSI-HF研究中,与安慰剂相比,n-3多不饱和脂肪酸(PUFA)使慢性心力衰竭患者的死亡率及心血管住院率略有降低,但瑞舒伐他汀对临床结局无影响。在HOME-HF研究中,与常规治疗相比,远程监测支持未能减少首次再住院或死亡时间,或存活且未住院的天数。

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