Sandhu Alexander T, Zheng Jimmy, Tisdale Rebecca L, Kohsaka Shun, Turakhia Mintu P, Heidenreich Paul A
Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, United States of America.
Medical Service, VA Palo Alto Health Care System, Palo Alto, CA, United States of America.
Am Heart J Plus. 2022 Oct;22:100210. doi: 10.1016/j.ahjo.2022.100210. Epub 2022 Sep 17.
This study aims to evaluate trends in guideline-directed medical therapy (GDMT) for patients with recent-onset heart failure with reduced ejection fraction (HFrEF) following the onset of the COVID-19 pandemic using an interrupted time series analysis in the Veteran's Affairs Healthcare System. Among 71,428 patients with recent-onset HFrEF between 1/1/2018 and 2/28/2021, we found the pandemic was not associated with differences in treatment rates for beta-blockers, renin-angiotensin-aldosterone system inhibitors, or mineralocorticoid receptor antagonists; there was a 2.6 % absolute decrease (95 % CI: 0.5 %-4.7 %) in ARNI rates in April 2020; which decreased over the pandemic. Despite the changes to healthcare delivery, the COVID-19 pandemic was associated with minimal changes in GDMT rates among patients with recent-onset HFrEF.
本研究旨在利用退伍军人事务医疗系统中的中断时间序列分析，评估2019冠状病毒病大流行后近期发生射血分数降低的心力衰竭（HFrEF）患者的指南导向药物治疗（GDMT）趋势。在2018年1月1日至2021年2月28日期间的71428例近期发生HFrEF的患者中，我们发现大流行与β受体阻滞剂、肾素-血管紧张素-醛固酮系统抑制剂或盐皮质激素受体拮抗剂的治疗率差异无关；2020年4月ARNI使用率绝对下降了2.6%（95%CI：0.5%-4.7%）；在大流行期间有所下降。尽管医疗服务发生了变化，但2019冠状病毒病大流行与近期发生HFrEF的患者中GDMT率的微小变化有关。
