Chambord Jérémy, Attivi David, Thuus Véronique, Zeghmouli Claire, Gibaud Stéphane
Department of Pharmacy, Centre hospitalier de l'Ouest Vosgien (CHOV), 1280 avenue de la division Leclerc, 88300, Neufchâteau, France.
Department of Cardiology, Centre hospitalier de l'Ouest Vosgien (CHOV), 1280 avenue de la division Leclerc, 88300, Neufchâteau, France.
Int J Clin Pharm. 2017 Jun;39(3):536-541. doi: 10.1007/s11096-017-0459-x. Epub 2017 Apr 3.
Background According to new recommendations for the management of acute decompensated heart failure (ADHF) in 2015, intravenous vasodilator therapy might be given as an early therapy when systolic blood pressure is normal to high (≥110 mmHg). Only 29% of patients with ADHF are treated with vasodilators without medical contraindication. Objective To evaluate the effect of the systematic use of ISDN on ADHF without contraindication especially on rehospitalization rate. Settings The 600-bed hospital (Centre Hospitalier de l'Ouest Vosgien, Neufchâteau, France). Methods This is a retrospective study with data analysed from medical records. Patients with ADHF episodes and hospitalization in the cardiology department or intensive care unit (ICU) between November 2013 and December 2015 were included resulting in 199 hospitalizations in the analysis (37 were treated by ISDN, and 162 were not). Main outcome measure Effects of ISDN on 180-day hospital readmission for ADHF or acute myocardial infarction (AMI), in-hospital mortality, length of stay, number of ICU admissions, and ICU length of stay. Results Patients who received ISDN required more ICU admissions than the other patients (54.1 vs 33.3%, p = 0.02). Nevertheless 180-day hospital readmission was lower for patients who were receiving ISDN (8.1 vs 22.8%, p = 0.04). ISDN did not influence other clinical outcomes tested. Conclusion ISDN may minimize or prevent the consequences of altered haemodynamics. Lower rehospitalization rate with ISDN was seen in this study.
根据2015年急性失代偿性心力衰竭（ADHF）管理的新建议，当收缩压正常至高（≥110 mmHg）时，静脉血管扩张剂治疗可作为早期治疗方法。在无医学禁忌证的ADHF患者中，只有29%接受了血管扩张剂治疗。目的：评估系统使用硝酸异山梨酯（ISDN）对无禁忌证的ADHF患者的影响，尤其是对再住院率的影响。研究地点：拥有600张床位的医院（法国讷沙托市西部孚日省中心医院）。方法：这是一项回顾性研究，对病历数据进行分析。纳入2013年11月至2015年12月在心脏病科或重症监护病房（ICU）发生ADHF发作并住院的患者，分析中共有199次住院（37例接受ISDN治疗，162例未接受）。主要观察指标：ISDN对ADHF或急性心肌梗死（AMI）180天再住院、住院死亡率、住院时间、ICU入住次数及ICU住院时间的影响。结果：接受ISDN治疗的患者比其他患者需要更多的ICU入住（54.1%对33.3%，p = 0.02）。然而，接受ISDN治疗的患者180天再住院率较低（8.1%对22.8%，p = 0.04）。ISDN对其他测试的临床结局无影响。结论：ISDN可能会最小化或预防血流动力学改变的后果。本研究中观察到使用ISDN可降低再住院率。
