...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>European journal of heart failure: journal of the Working Group on Heart Failure of the European Society of Cardiology >Improved pharmacological therapy of chronic heart failure in primary care: a randomized Study of NT-proBNP Guided Management of Heart Failure--SIGNAL-HF (Swedish Intervention study--Guidelines and NT-proBNP AnaLysis in Heart Failure).
【24h】

Improved pharmacological therapy of chronic heart failure in primary care: a randomized Study of NT-proBNP Guided Management of Heart Failure--SIGNAL-HF (Swedish Intervention study--Guidelines and NT-proBNP AnaLysis in Heart Failure).

机译：改善初级保健中慢性心力衰竭的药物治疗：NT-proBNP指导的心力衰竭管理的随机研究-SIGNAL-HF（瑞典干预研究-心力衰竭的指南和NT-proBNP分析）。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

AIMS: Treatment of chronic heart failure (CHF) guided by natriuretic peptides has been studied in clinical trials with conflicting results. The aim of this study was to investigate if N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided therapy in symptomatic heart failure patients in primary care would improve clinical outcomes over and above treatment according to guidelines. METHODS AND RESULTS: SIGNAL-HF was a 9 month, randomized, single-blind, parallel group study in patients with CHF in NYHA class II-IV, ejection fraction (EF)<50% and elevated NT-proBNP levels (males>800, females>1000 ng/L). All investigators underwent a pre-study educational programme about current CHF guidelines. A control group managed by non-trained investigators was considered not possible for ethical and practical reasons. Patients were randomized to structured treatment of CHF according to guidelines with or without NT-proBNP monitoring. The choice and dose of therapy for CHF was at the investigator's discretion. The primary outcome variable was the composite endpoint of days alive, days out of hospital, and symptom score from the Kansas City Cardiomyopathy Questionnaire. In all, 252 patients were randomized. The allocation groups were well balanced with regards to age, NT-proBNP, and EF. Treatment doses of beta-blockers and blockers of the renin-angiotensin-aldosterone system were markedly increased towards target doses and to a similar degree in both groups. There were no differences between the groups concerning either the primary endpoint (P=0.28) or its components [cardiovascular (CV) death, P=0.93; CV hospitalization, P=0.88; or symptom score, P=0.28]. CONCLUSION: NT-proBNP-guided CHF treatment did not result in important improvements in clinical outcomes in patients with CHF in primary care above and beyond what could be achieved by education and structured CHF treatment according to guidelines.
机译：目的：已经在临床试验中研究了利钠肽引导的慢性心力衰竭（CHF）的治疗，但结果相互矛盾。这项研究的目的是研究在初级保健中有症状心力衰竭患者中，N末端前B型利钠尿肽（NT-proBNP）指导的治疗是否可以根据指南改善临床疗效。方法和结果：SIGNAL-HF是一项9个月的随机，单盲，平行组研究，研究对象为NYHA II-IV级，CHF射血分数（EF）<50％和NT-proBNP水平升高（男性> 800）的CHF患者，女性> 1000 ng / L）。所有研究者都接受了有关当前瑞士法郎准则的预研究教育计划。出于道德和实践原因，认为未经训练的研究人员管理的对照组是不可能的。根据有无NT-proBNP监测的指导原则，将患者随机分组接受CHF的结构治疗。 CHF的治疗方法和剂量由研究者自行决定。主要结局变量是生存天数，住院天数和堪萨斯城心肌病问卷调查的症状评分的综合终点。总共有252名患者被随机分组​​。分配组在年龄，NT-proBNP和EF方面很均衡。两组的β受体阻滞剂和肾素-血管紧张素-醛固酮系统阻滞剂的治疗剂量均显着增加至目标剂量，并达到相似的程度。两组之间在主要终点（P = 0.28）或其组成方面无差异[心血管（CV）死亡，P = 0.93;简历住院，P = 0.88;或症状评分，P = 0.28]。结论：NT-proBNP指导的CHF治疗并没有导致CHF患者在初级保健中的临床结局得到重要改善，超出了根据指南进行的教育和结构化CHF治疗所能达到的水平。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号