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首页> 外文期刊>Circulation journal >Multicenter prospective investigation on efficacy and safety of carperitide for acute heart failure in the 'real world' of therapy.
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Multicenter prospective investigation on efficacy and safety of carperitide for acute heart failure in the 'real world' of therapy.

机译：在“现实世界”中对卡培利肽治疗急性心力衰竭的有效性和安全性进行的多中心前瞻性研究。

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BACKGROUND: Efficacy and safety assessments for carperitide (alpha-human atrial natriuretic peptide) in previous clinical trials have not mentioned its limitations in practice as therapy for acute heart failure. METHODS AND RESULTS: A 6-year prospective open-label registry analysis was conducted in the 'real world' of therapy for 3,777 patients with acute heart failure (male 57%, median age 73) treated with 0.085 microg . kg(-1) . min(-1) (median, interquartile 0.05-0.1) of carperitide for 65 h (median, interquartile 22-142); 51% were assessed as class III or IV according to the Killip classification; 82% of the patients were assessed as clinically improved after carperitide treatment. The efficacy limitation was related to the underlying disease (acute myocardial infarction), severity of Killip classification (Class IV), and renal function disturbance. The efficacy was significantly higher in patients with decompensated chronic heart failure (ie, cardiomyopathy, valvular diseases, and hypertensive heart disease). Incidence of adverse events was 16.9%, the most frequent being blood pressure lowering (9.5%), which occurred in the first 3 h of infusion, with 96% of patients recovering or improving without specific treatment. Logistic regression analysis revealed that factors predicting mortality (11.4%) during 7 days of follow-up were age, Killip classification, renal function disturbance, low blood pressure and use of vasopressors. CONCLUSION: The clinical condition improved in 82% of patients treated with carperitide. Based on these findings, minute strategy will be established for carperitide therapy within the strata of patient characteristics that may predict the prognosis.
机译：背景：在先前的临床试验中，卡培利肽（α-人心钠素）的疗效和安全性评估并未提及其在治疗急性心力衰竭中的局限性。方法和结果：在“现实世界”中对3777例接受0.085微克治疗的急性心力衰竭患者（男性57％，中位年龄73岁）进行了为期6年的前瞻性开放式注册表分析。千克（-1） min（-1）（中位数，四分位间0.05-0.1）的卡哌利特65 h（中位数，四分位间22-142）;根据基利普分类法，有51％被评估为III级或IV级;接受卡培肽治疗后，有82％的患者被评估为临床好转。功效限制与潜在疾病（急性心肌梗塞），Killip分类的严重程度（IV级）和肾功能障碍有关。在失代偿性慢性心力衰竭（即心肌病，瓣膜疾病和高血压性心脏病）患者中，疗效显着更高。不良事件的发生率为16.9％，最常见的是血压下降（9.5％），发生在输注的前3小时，有96％的患者未经特殊治疗即可恢复或好转。 Logistic回归分析显示，在随访的7天中，预测死亡率（11.4％）的因素是年龄，Killip分类，肾功能障碍，低血压和使用升压药。结论：82％的卡哌利肽治疗的患者的临床状况得到改善。基于这些发现，将在可能预测预后的患者特征分层内建立卡培肽治疗的微小策略。

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