钙通道阻滞剂治疗与射血分数保留的心力衰竭患者死亡率的相关性。
Associations between calcium channel blocker therapy and mortality in heart failure with preserved ejection fraction.
机构信息
National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, No. 1 XiYuan CaoChang, Haidian District, Beijing 100091, China.
CCU, Beijing Changping Hospital of Integrated Chinese and Western Medicine, No. 219 Huangping Road, Changping District, Beijing 102208, China.
出版信息
Eur J Prev Cardiol. 2022 Jul 20;29(9):1343-1351. doi: 10.1093/eurjpc/zwac004.
AIMS
Treatment of heart failure with preserved ejection fraction (HFpEF) is urgently needed; however, effective treatments are lacking. Current evidence showed a possible association between the use of calcium channel blockers (CCBs) and improved outcomes in HFpEF patients. We aimed to investigate the impact of CCBs on mortality in patients with HFpEF.
METHODS AND RESULTS
This was a post hoc analysis of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial. The primary outcome was all-cause mortality. The secondary outcomes were cardiovascular and noncardiovascular mortality. We analysed hazard ratios (HRs) in patients taking CCBs compared with those not taking CCBs using Cox proportional hazard models. We considered 3440 HFpEF patients. The mean follow-up period was 3.4 ± 1.7 years, and 530 patients died during the study period. All-cause mortality rates in patients taking and not taking CCB were 37.3 and 50.8 events per 1000 person-years, respectively. The adjusted HR for all-cause mortality was significantly lower in those taking CCBs than those not taking CCBs [HR: 0.72, 95% confidence interval (CI): 0.59-0.88, P = 0.001]. The risk of cardiovascular and noncardiovascular mortality was also significantly lower in patients taking CCBs than in those not taking CCBs (HR: 0.75, 95% CI: 0.59-0.96, P = 0.023 and HR: 0.68, 95% CI: 0.49-0.93, P = 0.018, respectively).
CONCLUSION
The use of CCBs was associated with reduced risks of mortality in patients with HFpEF.
目的
心力衰竭伴射血分数保留（HFpEF）的治疗迫在眉睫，但缺乏有效治疗方法。现有证据表明，钙通道阻滞剂（CCB）的使用与 HFpEF 患者结局改善之间可能存在关联。我们旨在研究 CCB 对 HFpEF 患者死亡率的影响。
方法和结果
这是醛固酮拮抗剂治疗保留心功能心力衰竭试验的事后分析。主要结局为全因死亡率。次要结局为心血管和非心血管死亡率。我们使用 Cox 比例风险模型分析了服用 CCB 与未服用 CCB 的患者的风险比（HR）。我们分析了 3440 例 HFpEF 患者。平均随访时间为 3.4±1.7 年，研究期间有 530 例患者死亡。服用和未服用 CCB 的患者的全因死亡率分别为 37.3 和 50.8 例/1000 人年。服用 CCB 的患者全因死亡率的调整 HR 明显低于未服用 CCB 的患者[HR：0.72，95%置信区间（CI）：0.59-0.88，P=0.001]。服用 CCB 的患者心血管和非心血管死亡率的风险也明显低于未服用 CCB 的患者（HR：0.75，95%CI：0.59-0.96，P=0.023 和 HR：0.68，95%CI：0.49-0.93，P=0.018）。
结论
在 HFpEF 患者中，使用 CCB 与降低死亡率风险相关。
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