University of Maryland School of Pharmacy, Baltimore, Maryland, USA.
Prisma Health, Columbia, South Carolina, USA.
Pharmacotherapy. 2021 Jun;41(6):537-545. doi: 10.1002/phar.2528. Epub 2021 Apr 29.
Patients with heart failure with reduced ejection fraction often have one or more noncardiovascular comorbidities. The presence of concomitant disease states is associated with worse outcomes, including increased risk of mortality, decreased quality of life, and increased healthcare resource utilization. Additionally, the presence of heart failure with reduced ejection fraction complicates the management of these comorbidities, including varying safety and efficacy of therapies compared to those without heart failure. This article will review the literature on the pharmacologic management of common noncardiovascular comorbidities-including chronic obstructive pulmonary disease, depression, diabetes mellitus, gout, chronic kidney disease, and iron deficiency-in patients with heart failure with reduced ejection fraction, as well as provide recommendations for appropriate treatment selection in this population.
患有射血分数降低的心力衰竭的患者通常存在一种或多种非心血管合并症。伴随疾病状态的存在与更差的结局相关，包括死亡率增加、生活质量下降和医疗保健资源利用增加。此外，射血分数降低的心力衰竭的存在使这些合并症的管理变得复杂，包括与没有心力衰竭的患者相比，治疗的安全性和有效性存在差异。本文将回顾关于射血分数降低的心力衰竭患者常见非心血管合并症（包括慢性阻塞性肺疾病、抑郁症、糖尿病、痛风、慢性肾脏病和缺铁）的药物治疗的文献，并为该人群的适当治疗选择提供建议。
