Association of colchicine use for acute gout with clinical outcomes in acute decompensated heart failure.
Association of colchicine use for acute gout with clinical outcomes in acute decompensated heart failure.
复制标题
秋水仙碱治疗急性痛风与急性失代偿性心力衰竭临床结局的相关性。
DOI：
10.1002/clc.23830
复制
发表时间：
2022-07
影响因子：
2.7
通讯作者：
Mazimba, Sula
中科院分区：
文献类型：
--
作者：
Roth, Mary E.;Chinn, Melissa E.;Dunn, Steven P.;Bilchick, Kenneth C.;Mazimba, Sula
痛风是心力衰竭（HF）患者常见的合并症，在失代偿性心力衰竭治疗期间常与急性加重相关。尽管秋水仙碱常用于治疗心力衰竭患者的急性痛风，但其在急性失代偿性心力衰竭期间使用对临床结局的影响尚不清楚。
这是一项单中心回顾性研究，研究对象为2011年3月至2020年12月期间因急性心力衰竭加重且伴有或不伴有急性痛风发作而住院的患者。我们评估了因痛风发作使用秋水仙碱治疗的患者与未发生痛风发作或未使用秋水仙碱的患者的临床结局。主要结局是住院期间全因死亡率。
在研究期间的1047例急性心力衰竭患者就诊中，有237例（22.7%）患者在入院期间因急性痛风也接受了秋水仙碱治疗。与对照组相比，秋水仙碱组住院期间全因死亡率显著降低（2.1%对6.5%，p = 0.009）。秋水仙碱组住院时间延长（9.93天对7.96天，p < 0.001），但30天再入院率无显著差异（21.5%对19.5%，p = 0.495）。在一个根据年龄调整的Cox比例风险模型中，住院期间使用秋水仙碱与出院生存率提高（风险比[HR] 0.163，95%置信区间[CI] 0.051 - 0.525，p = 0.002）以及住院期间心血管死亡率降低（HR 0.184，95% CI 0.044 - 0.770，p = 0.021）相关。
在心力衰竭加重的患者中，因痛风发作使用秋水仙碱治疗与未因急性痛风接受治疗的患者相比，住院期间死亡率显著降低。
Gout is a common comorbidity in heart failure (HF) patients and is frequently associated with acute exacerbations during treatment for decompensated HF. Although colchicine is often used to manage acute gout in HF patients, its impact on clinical outcomes when used during acute decompensated HF is unknown. This was a single center, retrospective study of hospitalized patients treated for an acute HF exacerbation with and without acute gout flare between March 2011 and December 2020. We assessed clinical outcomes in patients treated with colchicine for a gout flare compared to those who did not experience a gout flare or receive colchicine. The primary outcome was in‐hospital all‐cause mortality. Among 1047 patient encounters for acute HF during the study period, there were 237 encounters (22.7%) where the patient also received colchicine for acute gout during admission. In‐hospital all‐cause mortality was significantly reduced in the colchicine group compared with the control group (2.1% vs. 6.5%, p = .009). The colchicine group had increased length of stay (9.93 vs. 7.96 days, p < .001) but no significant difference in 30‐day readmissions (21.5% vs. 19.5%, p = .495). In a Cox proportional hazards model adjusted for age, inpatient colchicine use was associated with improved survival to discharge (hazards ratio [HR] 0.163, 95% confidence interval [CI] 0.051−0.525, p = .002) and a reduced rate of in‐hospital CV mortality (HR 0.184, 95% CI 0.044−0.770, p = .021). Among patients with a HF exacerbation, treatment with colchicine for a gout flare was associated with significantly lower in‐hospital mortality compared with those not treated for acute gout.
登录
查看更多内容
影响因子：
37.8
作者：
Givertz MM;Anstrom KJ;Redfield MM;Deswal A;Haddad H;Butler J;Tang WH;Dunlap ME;LeWinter MM;Mann DL;Felker GM;O'Connor CM;Goldsmith SR;Ofili EO;Saltzberg MT;Margulies KB;Cappola TP;Konstam MA;Semigran MJ;McNulty SE;Lee KL;Shah MR;Hernandez AF;NHLBI Heart Failure Clinical Research Network
通讯作者：
NHLBI Heart Failure Clinical Research Network
影响因子：
4.9
作者：
Ranieri, Laura;Contero, Carolina;Andres, Mariano
通讯作者：
Andres, Mariano
影响因子：
24
作者：
Butler, Javed;Yang, Mei;Givertz, Michael M.
通讯作者：
Givertz, Michael M.
影响因子：
24
作者：
Allen, Larry A.;Hernandez, Adrian F.;Felker, G. Michael
通讯作者：
Felker, G. Michael
影响因子：
2.9
作者：
Jackson, Robert;Shiozawa, Aki;Choi, Hyon
通讯作者：
Choi, Hyon