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首页> 外文期刊>The American heart journal >Tolerability and dose-related effects of nebivolol in elderly patients with heart failure: data from the Study of the Effects of Nebivolol Intervention on Outcomes and Rehospitalisation in Seniors with Heart Failure (SENIORS) trial.
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Tolerability and dose-related effects of nebivolol in elderly patients with heart failure: data from the Study of the Effects of Nebivolol Intervention on Outcomes and Rehospitalisation in Seniors with Heart Failure (SENIORS) trial.

机译：奈必洛尔对老年心力衰竭患者的耐受性和剂量相关效应：奈必洛尔干预对心力衰竭老年患者结局和再住院影响的研究数据。

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BACKGROUND: The SENIORS trial showed that nebivolol reduced the risk of death or cardiovascular (CV) hospitalization in elderly patients with heart failure (HF). We aimed to assess tolerability and dose-related effects of the beta-blocker nebivolol in elderly patients from the SENIORS trial. METHODS: Patients assigned to nebivolol (n = 1031) were classified into 4 groups, according to the dose achieved at the end of titration phase (maintenance dose): 0 mg (n = 74), low dose (1.25 or 2.5 mg, n = 142), medium dose (5 mg, n = 127), and target dose (10 mg, n = 688) and compared with those allocated to placebo (n = 1030). Age, sex and ejection fraction were similar between the groups, but prior myocardial infarction, coronary revascularization, and serum creatinine levels were lower in patients who achieved higher maintenance doses of nebivolol. RESULTS: After adjustment, all-cause mortality or CV hospitalization was significantly reduced in the 10 mg dose group compared with placebo (hazard ratio [HR] 0.75, 95% CI 0.63-0.90) which was similar to the medium dose group (HR 0.73, 95% CI 0.52-1.02). The low dose group had an apparently lower benefit (HR 0.88, 95% CI 0.64-1.20), whereas patients unable to tolerate any dose of nebivolol had an increased risk of death or CV hospitalization (HR 1.95, 95% CI 1.38-2.75). CONCLUSIONS: The benefits of nebivolol in elderly patients with HF appear to be related to the maintenance dose achieved. Patients unable to tolerate any dose have the worst prognosis.
机译：背景：SENIORS试验显示奈必洛尔降低了老年心力衰竭（HF）患者的死亡或心血管（CV）住院风险。我们旨在评估SENIORS试验对老年患者的β受体阻滞剂奈比洛尔的耐受性和剂量相关的影响。方法：根据滴定阶段结束时达到的剂量（维持剂量），将归为奈比洛尔的患者（n = 1031）分为4组：0 mg（n = 74），低剂量（1.25或2.5 mg，n = 142），中等剂量（5 mg，n = 127）和目标剂量（10 mg，n = 688），并与分配给安慰剂的剂量（n = 1030）进行比较。两组之间的年龄，性别和射血分数相似，但在奈必洛尔维持剂量较高的患者中，先前的心肌梗塞，冠脉血运重建和血清肌酐水平较低。结果：调整后，与安慰剂相比，10 mg剂量组的全因死亡率或CV住院率显着降低（危险比[HR] 0.75，95％CI 0.63-0.90），与中剂量组相似（HR 0.73） ，95％CI 0.52-1.02）。低剂量组的获益明显较低（HR 0.88，95％CI 0.64-1.20），而不能耐受任何剂量奈必洛尔的患者死亡或心血管住院的风险增加（HR 1.95，95％CI 1.38-2.75）。 。结论：奈必洛尔对老年HF患者的益处似乎与维持剂量有关。无法耐受任何剂量的患者预后最差。

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