Chang Anna Marie, Pang Peter S, Butler Javed, Storrow Alan B, Levy Phillip D, Lindenfeld JoAnn, Collins Sean P
Department of Emergency Medicine, Thomas Jefferson University Hospital, 1020 Sansom St, Thompson Building Suite 239, Philadelphia, PA, 19107, USA.
Department of Emergency Medicine, Indiana University, Indianapolis, IN, USA.
Curr Heart Fail Rep. 2019 Feb;16(1):12-20. doi: 10.1007/s11897-019-0419-y.
Acute heart failure accounts for over one million hospital discharges annually. Current guidelines suggest treatments for AHF should begin "without delay" but this time interval has not been clearly defined.
Data suggest that certain treatments such as earlier treatment with diuretics and vasodilators may improve patient symptom relief, morbidity, and mortality. Secondary analyses of clinical trials of novel treatments under development have not shown similar results. The data are equivocal regarding the impact of early treatment in AHF on in-hospital and long-term morbidity and mortality. Improved clinical trial designs will help answer when and if "early" treatment should begin and whether it impacts short- and long-term outcomes in AHF.
急性心力衰竭每年导致超过100万例患者出院。当前指南建议对急性心力衰竭的治疗应“毫不延迟”地开始，但这一时间间隔尚未明确界定。
数据表明，某些治疗方法，如早期使用利尿剂和血管扩张剂进行治疗，可能会改善患者症状缓解情况、发病率和死亡率。对正在研发的新型治疗方法的临床试验进行的二次分析并未显示出类似结果。关于急性心力衰竭早期治疗对住院期间及长期发病率和死亡率的影响，数据并不明确。改进的临床试验设计将有助于回答何时以及是否应开始“早期”治疗，以及其是否会影响急性心力衰竭的短期和长期结局。
