School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan; and.
J Cardiovasc Pharmacol. 2023 Sep 1;82(3):229-234. doi: 10.1097/FJC.0000000000001451.
The authors report the impact of angiotensin receptor-neprilysin inhibitor (ARNI) versus renin-angiotensin system inhibitor (RASI) on the management and outcomes in dementia among heart failure (HF) patients as obtained from the real-life nationwide registry. In this study, HF patients between January 1, 2017 and December 31, 2019 were divided into 2 groups, including subjects receiving RASI and ARNI. The incidence rate of dementia was calculated with the unit of 1000 person-years. Cox proportional hazard model was applied for the examination of the hazard ratio, and also presented with 95% confidence interval. Between 2017 and 2019, RASI and ARNI cohorts contain 18,154 subjects. After adjusting with age, sex, comorbidities, and medications, ARNI cohort had a lower risk of dementia (adjusted hazard ratio = 0.83; 95% confidence interval = 0.72, 0.95) than RASI cohort. The authors concluded that use of ARNI was associated with a lower risk of new-onset dementia in patients with HF.
作者报告了从真实世界的全国性注册研究中获得的血管紧张素受体-脑啡肽酶抑制剂 (ARNI) 与肾素-血管紧张素系统抑制剂 (RASI) 对心力衰竭 (HF) 患者痴呆管理和结局的影响。在这项研究中，将 2017 年 1 月 1 日至 2019 年 12 月 31 日之间的 HF 患者分为 2 组，包括接受 RASI 和 ARNI 的患者。痴呆的发生率以每 1000 人年为单位计算。应用 Cox 比例风险模型检查风险比，并呈现 95%置信区间。在 2017 年至 2019 年期间，RASI 和 ARNI 队列包含 18154 名患者。在调整年龄、性别、合并症和药物后，ARNI 队列的痴呆风险较低（调整后的风险比=0.83；95%置信区间=0.72，0.95）。作者得出结论，ARNI 的使用与 HF 患者新发痴呆的风险降低相关。
