Department of Cardiology, University of Groningen, Groningen, The Netherlands.
Department of Cardiology, University of Groningen, Groningen, The Netherlands.
Can J Cardiol. 2014 Mar;30(3):288-95. doi: 10.1016/j.cjca.2013.12.005. Epub 2013 Dec 17.
Evidence-based treatment has succeeded in improving clinical outcomes in heart failure. Nevertheless, morbidity, mortality, and the economic burden associated with the syndrome remain unsatisfactorily high. Most landmark heart failure studies included broad study populations, and thus current recommendations dictate standardized, universal therapy. While most patients included in recent trials benefit from this background treatment, exceeding this already significant gain has proven to be a challenge. The early identification of responders and nonresponders to treatment could result in improved therapeutic effectiveness, while reduction of unnecessary exposure may limit harmful and unpleasant side effects. In this review, we examine the potential value of currently available information on differential responses to heart failure therapy-a first step toward personalized medicine in the management of heart failure.
循证治疗已成功改善心力衰竭的临床结局。然而，该综合征的发病率、死亡率和经济负担仍然高得令人不满意。大多数里程碑式的心力衰竭研究纳入了广泛的研究人群，因此目前的建议规定了标准化、普遍的治疗方法。虽然最近试验中大多数患者从这种背景治疗中受益，但要超越这一已经显著的获益一直是一个挑战。早期识别对治疗有反应和无反应的患者可能会提高治疗效果，而减少不必要的暴露可能会限制有害和不愉快的副作用。在这篇综述中，我们探讨了目前关于心力衰竭治疗反应差异的可用信息的潜在价值——这是心力衰竭管理中迈向个体化医疗的第一步。
