Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China.
Research Center for High Altitude Medicine of Qinghai University, Xining, 810001, China.
BMC Cardiovasc Disord. 2023 Jul 10;23(1):343. doi: 10.1186/s12872-023-03374-w.
In a large randomized controlled trial (PARADIGM-HF), ARNI has been shown to significantly reduce cardiovascular mortality and hospitalization for patients with reduced ejection fraction in heart failure. This study analyzed the efficacy and safety of ARNI on the basis of various types of heart failure patients in southwestern Sichuan Province.
This study included patients with heart failure who were treated at the Affiliated Hospital of North Sichuan Medical College from July 2017 to June 2021. This study analyzed the efficacy and safety of ARNI in the treatment of heart failure, and analyzed the risk factors for readmission after ARNI treatment.
After propensity score matching, a total of 778 patients were included in the study. The readmission rate for heart failure in patients treated with ARNI (8.7%) was significantly lower than that in the standard treatment group (14.5%) (P = 0.023). Both the proportion of patients with increased LVEF and with decreased LVEF were higher in the ARNI treatment group than in the conventional therapy group. Compared with receiving standard medical treatment, combined ARNI treatment resulted in a greater reduction in SBP (-10.00, 95%CI: -24.00-1.50 vs. -7.00, 95%CI: -20.00-4.14; P = 0.016) in HF patients. Combination ARNI therapy did not increase the risk of adverse events. The study found that age (> 65 vs. ≤65 years) (OR = 4.038, 95%CI: 1.360-13.641, P = 0.013) and HFrEF (OR = 3.162, 95%CI: 1.028-9.724, P = 0.045) were independent predictors of readmission in HF patients treated with ARNI.
Patients with heart failure treated with ARNI can improve clinical symptoms and reduce the risk of readmitted hospital admission. Age > ~ 65 years and HFrEF were independent predictors of readmission in HF patients treated in ARNI group.
在一项大规模随机对照试验(PARADIGM-HF)中,ARNI 已被证明可显著降低射血分数降低的心力衰竭患者的心血管死亡率和因心力衰竭住院的风险。本研究基于四川省西南部各种类型的心力衰竭患者,分析了 ARNI 的疗效和安全性。
本研究纳入了 2017 年 7 月至 2021 年 6 月在川北医学院附属医院接受治疗的心力衰竭患者。本研究分析了 ARNI 治疗心力衰竭的疗效,并分析了 ARNI 治疗后再入院的危险因素。
经过倾向评分匹配后,共有 778 例患者纳入研究。ARNI 治疗组心力衰竭再入院率(8.7%)明显低于标准治疗组(14.5%)(P=0.023)。ARNI 治疗组 LVEF 增加和 LVEF 降低的患者比例均高于常规治疗组。与接受标准药物治疗相比,联合 ARNI 治疗可使收缩压(SBP)降低更多(-10.00,95%CI:-24.00-1.50 比-7.00,95%CI:-20.00-4.14;P=0.016)。HF 患者联合 ARNI 治疗并未增加不良事件的风险。研究发现,年龄(>65 岁比≤65 岁)(OR=4.038,95%CI:1.360-13.641,P=0.013)和 HFrEF(OR=3.162,95%CI:1.028-9.724,P=0.045)是 ARNI 治疗的心力衰竭患者再入院的独立预测因素。
接受 ARNI 治疗的心力衰竭患者可改善临床症状,降低再入院风险。年龄>~65 岁和 HFrEF 是 ARNI 组心力衰竭患者再入院的独立预测因素。