Characteristics of "Stage D" heart failure: Insights from the acute Decompensated Heart Failure National registry Longitudinal Module (ADHERE LM)
Characteristics of "Stage D" heart failure: Insights from the acute Decompensated Heart Failure National registry Longitudinal Module (ADHERE LM)
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DOI：
10.1016/j.ahj.2007.10.020
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发表时间：
2008-02-01
影响因子：
4.8
通讯作者：
Wynne, Janet
中科院分区：
文献类型：
--
作者：
Costanzo, Maria R.;Mills, Roger M.;Wynne, Janet
背景 更好地了解“D 期”心力衰竭 (HF) 患者的特征、治疗和结果可能会改善患者的预后。我们对 ADHERE LM 进行了分析，以增强这种理解。方法 ADHERE LM 是一个多中心注册中心，专门设计用于前瞻性收集慢性 D 期心力衰竭的观察数据。对研究结果进行了分析，并与 ADHERE CM 的数据进行比较，ADHERE CM 是一个多中心注册中心，旨在前瞻性地收集整个急性失代偿性心力衰竭谱系的数据。采用描述性统计和 Kaplan-Meier 分析来评估 ADHERE LM 中所有 1433 名患者的数据。 结果 与急性失代偿性心力衰竭患者相比，慢性 D 期心力衰竭患者往往更年轻（69.6 岁 vs 72.8 岁）、男性（65% vs 49%）、患有高脂血症/血脂异常（65% vs 41%）以及患有冠状动脉疾病（73% vs 41%）。 57%）。在 D 期患者中，静脉利尿剂（73%）和血管活性药物（84%）的使用很常见。 Kaplan-Meier 估计的 1 年生存率为 71.9% (95% CI 69.3%-74.5%)，估计 1 年无住院或死亡率为 32.9% (95% CI 30.2%-35.6%)。 结论 D 期心力衰竭患者通常是患有血脂异常和冠状动脉疾病的男性。发病率和死亡率很高。基于具有不同特征的心力衰竭患者的研究的治疗决策可能不适用；需要进行更多研究来确定这些患者的最佳治疗方案。
Background An improved understanding of the characteristics, treatment, and outcome of patients with "Stage D" heart failure (HF) may improve patient outcomes. We conducted an analysis of the ADHERE LM to enhance this understanding.Methods ADHERE LM is a multicenter registry designed specifically to prospectively collect observational data on chronic Stage D HF. The findings were analyzed and compared to data from ADHERE CM, a multicenter registry designed to prospectively collect data on the entire spectrum of acute decompensated HF. Descriptive statistics and Kaplan-Meier analysis were used to evaluate data from all 1433 patients in ADHERE LM.Results Compared to patients with acute decompensated HF, patients with chronic Stage D HF tended to be younger (69.6 vs 72.8 years), males (65% vs 49%), with hyperlipidemia/dyslipidemia (65% vs 41%), and with coronary artery disease (73% vs 57%). In Stage D patients, use of intravenous diuretics (73%) and vasoactive agents (84%) was common. Kaplan-Meier-estimated 1-year survival was 71.9% (95% Cl 69.3%-74.5%) and estimated 1-year freedom from hospitalization or death was 32.9% (95% CI 30.2%-35.6%).Conclusions Patients with Stage D HF are frequently males with dyslipidemia and coronary artery disease. Morbidity and mortality are high. Therapeutic decisions based on studies in HF patients with different characteristics may not be applicable; additional research is needed to determine optimal therapeutic regimens for these patients.