Carrizales-Sepúlveda Edgar Francisco, Ordaz-Farías Alejandro, Vargas-Mendoza José Arturo, Vera-Pineda Raymundo, Flores-Ramírez Ramiro
Cardiology Service, Hospital Universitario "Dr José E González", Universidad Autónoma de Nuevo León Monterrey, Nuevo León, Mexico.
Heart Failure Unit, Cardiology Service, Hospital Universitario "Dr José E González", Universidad Autónoma de Nuevo León Monterrey, Nuevo León, Mexico.
Card Fail Rev. 2024 Mar 6;10:e03. doi: 10.15420/cfr.2023.20. eCollection 2024.
Treatment for heart failure has experienced a major revolution in recent years, and current evidence shows that a combination of four medications (angiotensin receptor-neprilysin inhibitors + β-blockers + mineralocorticoid receptor antagonists + sodium.glucose cotransporter 2 inhibitors) offer the greatest benefit to our patients with significant reductions in cardiovascular mortality, heart failure hospitalisations and all-cause mortality. Unfortunately, despite their proven benefits, the implementation of these therapies is still low. Clinical inertia, and unfounded fear of using these drugs might contribute to this. Recently, evidence from randomised clinical trials has shown that intensive implementation of these therapies in patients with heart failure is safe and effective. In this review, we attempt to tackle some of these misconceptions/fears regarding medical therapy for heart failure and discuss the available evidence showing the best strategies for implementation of these therapies.
近年来，心力衰竭的治疗发生了重大变革，目前的证据表明，四种药物联合使用（血管紧张素受体脑啡肽酶抑制剂+β受体阻滞剂+盐皮质激素受体拮抗剂+钠-葡萄糖协同转运蛋白2抑制剂）能为患者带来最大益处，可显著降低心血管死亡率、心力衰竭住院率和全因死亡率。不幸的是，尽管这些疗法已被证实有益，但它们的应用率仍然很低。临床惰性以及对使用这些药物毫无根据的恐惧可能是造成这种情况的原因。最近，随机临床试验的证据表明，在心力衰竭患者中强化应用这些疗法是安全有效的。在这篇综述中，我们试图解决一些关于心力衰竭药物治疗的误解/恐惧，并讨论现有证据所显示的实施这些疗法的最佳策略。
