Clin-STAR corner: Practice changing advances in cardiology.
Clin-STAR corner: Practice changing advances in cardiology.
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Clin-STAR 角：实践心脏病学不断变化的进步。
DOI：
10.1111/jgs.18201
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发表时间：
2023
影响因子：
6.3
通讯作者：
Rich,MichaelW
中科院分区：
文献类型：
--
作者：
Husaini,Mustafa;Rich,MichaelW
尽管心血管疾病是老年人死亡和主要残疾的主要原因，但在大多数心血管临床试验中，老年患者的代表性一直不足。本文总结了2020年至2022年发表的四项试验的结果，这些试验具有直接适用于老年人护理的实践改变意义。这些试验的关键结果是：（1）即使在中度或重度缺血的情况下，对选定的稳定性缺血性心脏病患者进行初始保守治疗也是合理的;（2）恩格列净可有效减少心力衰竭和射血分数保留患者（伴或不伴糖尿病）的心力衰竭住院率;（3）个体化的物理康复计划减少了因心力衰竭住院的老年患者的失调和功能下降;（4）将膳食钠摄入量限制在1500 mg/天以下不太可能改善大多数心力衰竭患者的预后。
Although cardiovascular disease is the leading cause of death and major disability in older adults, older patients have been consistently under‐represented in most cardiovascular clinical trials. This article summarizes the results of four trials published from 2020 to 2022 with practice‐changing implications directly applicable to the care of older adults. The key findings from these trials were that: (1) an initial conservative approach to managing selected patients with stable ischemic heart disease is reasonable, even in the setting of moderate or severe ischemia; (2) empagliflozin is effective in reducing heart failure hospitalizations in patients with heart failure and preserved ejection fraction, with or without diabetes; (3) an individually tailored physical rehabilitation program reduces deconditioning and functional decline in older patients hospitalized with heart failure; and (4) restricting dietary sodium intake to less than 1500 mg/day is unlikely to improve outcomes in most patients with heart failure.