Fingolimod: contraindicated in patients with a history of cardiovascular disease

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Fingolimod: contraindicated in patients with a history of cardiovascular disease

机译：Fingolimod：患有心血管疾病史的患者禁忌

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Fingolimods an orally administered immuno-suppressant, approved for use in adults with multiple sclerosis. In this situation, the first-line treatment is an injectable beta interferon, in the absence of anything better. The harm-benefit balance of other "disease-modifying" drugs is no better, and can even be worse, than that of beta interferon (1). Cardiac adverse effects of fingolimod such as dose-dependent brachycardia were already identified in clinical trials performed before marketing authorisation. Subsequently, cardiovascular deaths (sudden death, myocardial infarction or cardiac rhythm disorders) have been reported (2,3). At the end of 2017, fingolimod became contra-indicated in patients having had, during the previous 6 months, a myocardial infarct, unstable angina, stroke, a transient ischaemic attack, decompensated or class III/IV heart failure, and in patients with cardiac arrhythmia, with 2nd or 3rd degree atrioventricular block, or having a QT interval on the electrocardiogram greater than or equal to 500 msec. This measure was taken following an analysis by the European Pharma-covigilance Risk Assessment Committee (PRAC) of 48 cases of ventricular arrhythmias attributable to fingolimod, of which 9 were fatal. The 9 patients who died all had a history of heart disease (4,5).

机译：Fingolimod批准用于具有多发性硬化的成年人的口服施用免疫抑制剂。在这种情况下，第一线治疗是一种可注射的β干扰素，在没有更好的情况下的情况下。其他“疾病修饰”药物的危害效益平衡并不更好，并且甚至可能比β干扰素（1）更差。在营销授权前进行的临床试验中已经鉴定了Fingolimod如剂量依赖性血糖卡的心脏不良影响。随后，已经报道了心血管死亡（猝死，心肌梗死或心脏节律疾病）（2,3）。截至2017年底，佛教莫德在前6个月，心肌梗塞，不稳定的心绞痛，中风，短暂性缺血性攻击，失代偿或III级/ III型心力衰竭中，对患者进行了矛盾的患者，并在心脏病患者中表明心律失常，具有第二或第3度的房室间块，或者在电磁图上具有Qt间隔，大于或等于500毫秒。在欧洲药物 - 社会风险评估委员会（PRAC）的分析后48例归因于Fingolimod的心间心律失常的分析，其中9例是致命的。所有死亡的9例患者都有心脏病历史（4,5）。

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《Prescrire international》 |2018年第195期|共1页
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1. Fingolimod: contraindicated in patients with a history of cardiovascular disease [J] . Prescrire international . 2018,第195期

机译：Fingolimod：患有心血管疾病史的患者禁忌
2. Influence of family history of cardiovascular disease on clinicians' preventive recommendations and subsequent adherence of patients without cardiovascular disease [J] . Zlot A.I., Valdez R., Han Y., Public health genomics . 2010,第7a8期

机译：心血管疾病的家族病史对临床医生的预防性推荐以及无心血管疾病患者的依从性的影响
3. Aspirin for Primary Cardiovascular Prevention in Patients with Family History of Cardiovascular Disease: Meta-analysis [J] . Antunes Miguel M., Alves Mariana, Ferreira Joaquim J., Cardiovascular drugs and therapy . 2021,第4期

机译：心血管疾病家族病史患者的原发性心血管预防阿司匹林：Meta分析
4. SVM Classification for Discriminating Cardiovascular Disease Patients from Non-cardiovascular Disease Controls Using Pulse Waveform Variability Analysis [C] . Kuanquan Wang, Lu Wang, Dianhui Wang, Australian Joint Conference on Artificial Intelligence; 20041204-06; Cairns(AU) . 2004

机译：使用脉搏波形变异性分析将SVM分类从非心血管疾病控制中区分出来
5. Role of patients' perception of barriers to taking medication on medication adherence among patients with diabetes: Development and psychometric evaluation of the Murage-Marrero- Monahan Medication barriers scale (4M scale), patient characteristics associated with medication barriers, and association of medication barriers and cardiovascular disease (CVD) risk. [D] . Murage, Mwangi James. 2014

机译：糖尿病患者对患者服药障碍的感知对药物依从性的作用：Murage-Marrero-Monahan药物障碍量表（4M量表），与药物障碍相关的患者特征以及药物障碍和心血管疾病（CVD）的风险。
6. Efficacy and safety of canagliflozin in patients with type 2 diabetes based on history of cardiovascular disease or cardiovascular risk factors: a post hoc analysis of pooled data [O] . Michael J. Davies, Katherine Merton, Ujjwala Vijapurkar, 2017

机译：根据心血管疾病病史或心血管危险因素卡格列净对2型糖尿病患者的疗效和安全性：汇总数据的事后分析
7. P569Diastolic dyssynchrony is associated with exercise intolerance in hypertensive patients with left ventricular hypertrophyP570Echocardiographic pattern of acute pulmonary embolism, analysis of consecutive 511 patientsP571Clinical significance of ventricular interdependence and left ventricular function in patients with pulmonary hypertension receiving specific vasodilator therapyP572Haemodynamic characteristics and ventricular mechanics in post-capillary and combined pre- and post-capillary pulmonary hypertensionP573Relationship between hematological response and echocardiographic features in patients with light chains systemic amyloidosisP574Myocardial changes in patients with anorexia nervosaP575Giant cell arteritis presenting as fever of unknown origin: role of clinical history, early positron emission tomography and ultrasound screeningP576Subclinical systolic dysfunction in systemic sclerosis is not influenced by standard rheumatologic therapy - a 4D echocardiographic studyP577Cardiac index correlates with the degree of hepatic steathosis in obese patients with obstructive sleep apneaP578Myocardial mechanics in top-level endurance athletes: a three-dimensional speckle tracking studyP579The athlete heart: what happens to myocardial deformation in physiological adaptation to sportsP580Association between left ventricle intrinsic function and urine protein-creatinine ratio in preeclampsia before and after deliveryP581Dilatation of the aorta in children with bicuspid aortic valveP582Cardiovascular functional abnormalities in patients with osteogenesis imperfectaP583Dobutamine stress test fast protocol: diagnostic accuracy and securityP584Prognostic value of non-positive exercise echocardiography in the patients submitted to percutaneous coronary interventionP585The use of myocardial strain imaging in the detection of coronary artery disease during stress echocardiographyP586Preserved O2 extraction exercise response in heart failure patients with chronotropic insufficiency: evidence for a central cardiac rather than peripheral oxygen uptake limitationP587Major determinant of O2 artero-venous difference at peak exercise in heart failure and healthy subjectsP588Stress echocardiography with contrast perfusion analysis for a more sensitive test for ischemic heart diseaseP589Assessment of mitral annular physiology in myxomatous mitral disease with 3D transesophageal echocardiography: comparison between early severe mitral regurgitation and decompensated groupP590Three-dimensional transesophageal echocardiographic assessment of the mitral valve geometry in patients with mild, moderate and severe chronic ischemic mitral regurgitationP591Left atrial appendage closure. Multimodality imaging in device size selectionP592Contributions of three-dimensional transesophageal echocardiography in the evaluation of aortic atherosclerotic plaquesP593Agitated blood-saline is superior to agitated air-saline for echocardiographic shunt studies [O] . IH. Jung, K. Kurnicka, R. Enache, 2016

机译：P569DiaStolic Dyssynchrony与患有左心室血液高效患者的锻炼性不耐受急性肺栓塞模式，分析肺动脉高血压患者心室相互依存和左心室功能的连续511例患者分析，患者患者患者毛细血管分析并结合毛细血管肺炎患者血液响应和超声心动图特征的预毛细血管肺动脉高压和毛细血管肺炎术患者患者厌食症患者患者的血液学响应和超声心动图。系统硬化症中的收缩功能障碍不受标准风湿病治疗的影响 - 4D超声心动图STOPYP577心脏指数与肥胖睡眠Apneap578Myocardial机制在顶级耐力运动员中的肝脏病变程度相关：三维散斑跟踪STOPYP579运动员心脏：心肌变形在生理调整中的心肌变形，左心室内部功能之间的运动量和诊断的准确性，并在患者提交经皮冠状动脉非正运动超声心动图的securityP584Prognostic值：在之前并与患者的骨生成imperfectaP583Dobutamine压力测试快速协议叶主动脉valveP582Cardiovascular功能异常儿童主动脉deliveryP581Dilatation后先兆子痫尿蛋白肌酐比干预措施，使用心力学超声术治疗冠状动脉疾病检测心肌菌株在心力衰竭患者中冠状动脉疾病中的使用Qufibess：中央心脏的证据，而不是外周氧气摄取限制，心力衰竭和健康主题SP588静脉内超声心动图的峰锻炼中O2动脉差异的差异，具有对比灌注分析，对近视二尖瓣缺血性心脏病的缺血性心脏病的更敏感性分析。疾病与3D异口管超声心动图：早期严重二尖瓣流动和失代偿的血清瓣膜瓣膜瓣膜几何学患者的肝硬化，中度慢性缺血二尖瓣术术患者的比较。器件尺寸的多模成像选择P592的三维经细胞激素超声心动图在主动脉动脉粥样硬化PLAQUESC593致血液中的评估中的血液 - 盐水优于超声心动图分流研究的搅拌空气 - 盐水

Fingolimod: contraindicated in patients with a history of cardiovascular disease

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