Association of Valproic Acid Use With Post-Myocardial Infarction Heart Failure Development: A Meta-Analysis of Two Retrospective Case-Control Studies.
Association of Valproic Acid Use With Post-Myocardial Infarction Heart Failure Development: A Meta-Analysis of Two Retrospective Case-Control Studies.
复制标题
DOI：
10.1177/10742484221140303
复制
发表时间：
2022-01
影响因子：
2.6
通讯作者：
Luzum, Jasmine A.
中科院分区：
文献类型：
--
作者：
English, Joseph D.;Tian, Shuo;Wang, Zhong;Luzum, Jasmine A.
尽管在治疗方面取得了进展，心肌梗死(MI)仍然是全球发病率和死亡率的重要原因。我们的团队此前已经证明，丙戊酸(VPA)对心肌梗死后的大鼠具有心脏保护作用。这项研究的目的是调查丙戊酸的使用与人类心肌梗塞后心力衰竭(HF)的发展之间的关系。这项研究是从电子健康记录(密歇根医学)和索赔数据(OpumInsight)收集的两项回溯性病例对照研究的随机效应荟萃分析。根据多种人口统计学和临床特征，MI时有VPA有效处方的患者与MI时未服用VPA的对照组进行1：4的配对。使用Fine-Gray竞争风险模型对VPA处方药和非VPA处方药的主要结果，即发生心衰的时间进行分析。对不同剂量的VPA(1000 mg/天与1000 mg/天与0 mg/天)的相关性进行了探索性分析。总共，数据集包括1313名患者(249例患者和1064名对照)。在荟萃分析中，心肌梗死期间任何剂量的VPA对心梗后发生的心力衰竭都有保护作用(HR=0.87；95%CI=0.72-1.01)。然而，当按剂量分层时，大剂量VPA(1000 mg/天)与心梗后心力衰竭风险降低30%显著相关(HR=0.70；95%CI=0.49-0.91)，而小剂量VPA(1000 mg/天)并不显著(HR 0.95；95%CI=0.78-1.13)。VPA剂量≥1,000 mg/天可提供心肌梗死后的心脏保护，从而降低心力衰竭的发生率。
Despite advances in treatments, myocardial infarction (MI) remains a significant cause of morbidity and mortality worldwide. Our team has previously shown that valproic acid (VPA) is cardio-protective when administered to rats post-MI. The aim of this study was to investigate the association of VPA use with post-MI heart failure (HF) development in humans. This study was a random effects meta-analysis of two retrospective case–control studies collected from electronic health record (Michigan Medicine) and claims data (OptumInsight). Cases with an active prescription for VPA at the time of their MI were matched 1:4 to controls not taking VPA at the time of their MI by multiple demographic and clinical characteristics. The primary outcome, time-to-HF development, was analyzed using the Fine-Gray competing risks model of any VPA prescription versus no VPA prescription. An exploratory analysis was conducted to evaluate the association of different VPA doses (1000 mg/day vs <1000 mg/day vs 0 mg/day VPA). In total, the datasets included 1313 patients (249 cases and 1064 controls). In the meta-analysis, any dose of VPA during an MI tended to be protective against incident HF post-MI (HR = 0.87; 95% CI = 0.72–1.01). However, when stratified by dose, high-dose VPA (1000 mg/day) significantly associated with 30% reduction in risk for HF post-MI (HR = 0.70; 95% CI = 0.49–0.91), whereas low-dose VPA (<1000 mg/day) did not (HR 0.95; 95% CI = 0.78–1.13). VPA doses ≥1000 mg/day may provide post-MI cardio-protection resulting in a reduced incidence of HF.
登录
查看更多内容
影响因子：
24
作者：
Amsterdam, Ezra A.;Wenger, Nanette K.;Zieman, Susan J.
通讯作者：
Zieman, Susan J.
影响因子：
6.5
作者：
Kim, Kyuseok;Li, Yongqing;Jin, Guang;Chong, Wei;Liu, Baoling;Lu, Jennifer;Lee, Kyoungbun;deMoya, Marc;Velmahos, George C.;Alam, Hasan B.
通讯作者：
Alam, Hasan B.
丙戊酸可预防缺血再灌注损伤模型中的肾功能障碍和炎症。
影响因子：
--
作者：
Costalonga EC;Silva FM;Noronha IL
通讯作者：
Noronha IL
影响因子：
4.5
作者：
Huo, Jinhai;Yang, Ming;Shih, Ya-Chen Tina
通讯作者：
Shih, Ya-Chen Tina
DOI：
10.1177/1055665619882568
发表时间：
2020-03-01
期刊：
CLEFT PALATE-CRANIOFACIAL JOURNAL
影响因子：
--
作者：
Bennett, Katelyn G.;Gunaseelan, Vidhya;Buchman, Steven R.
通讯作者：
Buchman, Steven R.