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首页> 外文期刊>Current cardiology reviews. >Evolution of biomarker guided therapy for heart failure: Current concepts and trial evidence
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Evolution of biomarker guided therapy for heart failure: Current concepts and trial evidence

机译：生物标志物指导心力衰竭治疗的演变：最新概念和试验证据

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Optimizing management of patients with heart failure remains quite challenging despite many significant advances in drug and device therapy for this syndrome. Although a large body of evidence from robust clinical trials supports multiple therapies, utilization of these well-established treatments remains inconsistent and outcomes suboptimal in “real-world” patients with heart failure. Disease management programs may be effective, but are difficult to implement due to cost and logistical issues. Another approach to optimizing therapy is to utilize biomarkers to guide therapeutic choices. Natriuretic peptides provide additional information of significant clinical value in the diagnosis and estimation of risk inpatients with heart failure. Ongoing research suggests a potential important added role for natriuretic peptides in heart failure. Guiding therapy based on serial changes in these biomarkers may be an effective strategy to optimize treatment and achieve better outcomes in this syndrome. Initial, innovative, proof-of-concept studies have provided encouraging results and important insights into key aspects of this strategy, but well designed, large-scale, multicenter, randomized, outcome trials are needed to definitively establish this novel approach to management. Given the immense and growing public health burden of heart failure, identification of cost-effective ways to decrease the morbidity and mortality due to this syndrome is critical.
机译：尽管针对该综合征的药物和设备治疗取得了许多重大进展，但优化心力衰竭患者的治疗仍然具有很大挑战。尽管来自可靠的临床试验的大量证据支持多种疗法，但是在“现实世界”的心力衰竭患者中，这些行之有效的疗法的使用仍然不一致，结果也不理想。疾病管理计划可能是有效的，但是由于成本和后勤问题而难以实施。优化治疗的另一种方法是利用生物标记物指导治疗选择。利钠肽为诊断和评估心力衰竭患者的风险提供了具有重要临床价值的附加信息。正在进行的研究表明，利钠肽在心力衰竭中可能具有重要的附加作用。基于这些生物标志物系列变化的指导治疗可能是一种有效的策略，可以优化治疗并在该综合征中取得更好的疗效。初步的，概念验证的创新研究为该策略的关键方面提供了令人鼓舞的结果和重要见解，但需要精心设计的大规模，多中心，随机，结果试验来明确确立这种新颖的管理方法。鉴于心力衰竭的巨大且日益增加的公共卫生负担，确定降低这种综合征的发病率和死亡率的经济有效方法至关重要。

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