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沙库巴曲缬沙坦治疗透析终末期肾病慢性心力衰竭患者的效果。

Effects of sacubitril-valsartan in the treatment of chronic heart failure patients with end-stage renal disease undergoing dialysis.

机构信息

Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin, China.

出版信息

Clin Cardiol. 2023 Aug;46(8):930-936. doi: 10.1002/clc.24075. Epub 2023 Jun 28.

Abstract

BACKGROUND

The data on the effects of the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril-valsartan (LCZ696) in chronic heart failure (CHF) patients with end-stage renal disease (ESRD) requiring dialysis are lacking. This study assessed the efficacy and safety of LCZ696 in CHF patients with ESRD on dialysis.

HYPOTHESIS

LCZ696 treatment can reduce rehospitalization rate for HF, delay the occurrence of rehospitalization for HF, and prolong the survival time.

METHODS

We retrospectively analyzed the clinical data of CHF patients with ESRD on dialysis who were admitted to the Second Hospital of Tianjin Medical University from August 2019 to October 2021.

RESULTS

Sixty-five patients had primary outcome during the follow-up. The incidence of rehospitalization for HF in the control group was significantly higher than that in the LCZ696 group (73.47% vs. 43.28%, p = .001). There was no significant difference in mortality between the two groups (8.96% vs. 10.20%, p = 1.000). Our study included a time-to-event analysis through 1 year for the primary outcome-Kaplan-Meier curve showed that the LCZ696 group had significantly longer free-event survival time than the control group over 1-year follow-up (median survival time 139.0 days vs. 116.0 days, p = .037).

CONCLUSIONS

Our study found that LCZ696 treatment was associated with a reduction in HF rehospitalization without significant effects on serum creatinine and serum potassium levels. LCZ696 is effective and safe in CHF patients with ESRD on dialysis.

摘要

背景

缺乏血管紧张素受体-脑啡肽酶抑制剂(ARNI)沙库巴曲缬沙坦(LCZ696)在需要透析的终末期肾病(ESRD)慢性心力衰竭(CHF)患者中疗效的数据。本研究评估了 LCZ696 在 ESRD 透析的 CHF 患者中的疗效和安全性。

假说

LCZ696 治疗可降低 HF 再住院率,延迟 HF 再住院的发生,并延长生存时间。

方法

我们回顾性分析了 2019 年 8 月至 2021 年 10 月期间天津医科大学第二医院收治的 ESRD 透析的 CHF 患者的临床资料。

结果

65 例患者在随访期间发生主要结局。对照组 HF 再住院发生率明显高于 LCZ696 组(73.47%比 43.28%,p=0.001)。两组死亡率无显著性差异(8.96%比 10.20%,p=1.000)。我们的研究包括对主要结局的时间事件分析——Kaplan-Meier 曲线显示,LCZ696 组在 1 年的随访中无事件生存时间明显长于对照组(中位生存时间 139.0 天比 116.0 天,p=0.037)。

结论

我们的研究发现,LCZ696 治疗可降低 HF 再住院率,而对血清肌酐和血清钾水平无显著影响。LCZ696 在 ESRD 透析的 CHF 患者中有效且安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b00b/10436793/ea5d5d610d6a/CLC-46-930-g003.jpg

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