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首页> 外文期刊>The American Journal of Cardiology >Using Natriuretic Peptides for Selection of Patients in Acute Heart Failure Clinical Trials
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Using Natriuretic Peptides for Selection of Patients in Acute Heart Failure Clinical Trials

机译：使用利钠肽选择急性心力衰竭临床试验中的患者

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摘要

Actite heart failure (AHF) is a complex syndrome with presentations ranging from hypotensive cardiogenic shock to hypertensive emergency with pulmonary edema. Most patients with AHF present with worsening of chronic HF signs and symptoms over days to weeks, and significant heterogeneity exists. It can, therefore, be challenging to characterize the overall population. The complexity of defining the AHF phenotype has been cited as a contributing cause for neutral results in most pharmacologic trials in patients with AHF Dyspnea has been a routine inclusion criterion for AHF for over a decade, but the utility of current instruments for dyspnea assessment has been called into question. Furthermore, the threshold of clinical severity that prompts patient admission of an HF clinic visit may vary substantially across regions in global trials. Therefore, the inclusion of cardiac-specific biomarkers has been incorporated into AHF trials as 1 strategy to support inclusion of the target patient population and potentially enrich the population with patients at risk for clinical outcomes. In conclusion, we discuss strategies to support appropriate patient selection in AHF trials with an emphasis on using biomarker criteria that may improve the likelihood of success with future AHF clinical trials. (C) 2015 Elsevier Inc. All rights reserved.
机译：腹肌性心力衰竭（AHF）是一种复杂的综合征，表现形式从低血压性心源性休克到高血压急症伴有肺水肿。大多数AHF患者在数天至数周内表现出慢性HF症状和体征恶化，并且存在明显的异质性。因此，表征总体人口可能具有挑战性。在大多数药理试验中，定义AHF表型的复杂性是导致AHF呼吸困难的中性结果的一个成因，十多年来，它一直是AHF的常规纳入标准，但目前用于呼吸困难评估的仪器已被广泛使用。受到质疑。此外，在全球性试验中，促使患者接受HF门诊就诊的临床严重性阈值可能在各个地区大不相同。因此，包括心脏特异性生物标志物已作为一种策略纳入AHF试验中，以支持纳入目标患者人群并可能使有临床结果风险的患者人群更加丰富。总之，我们讨论了在AHF试验中支持适当患者选择的策略，重点是使用生物标志物标准，这可能会提高将来AHF临床试验成功的可能性。 （C）2015 Elsevier Inc.保留所有权利。

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