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首页> 外文期刊>Cardiovascular therapeutics >Underutilization of IV Nitrates in the Treatment of Acute Heart Failure
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Underutilization of IV Nitrates in the Treatment of Acute Heart Failure

机译：硝酸盐在急性心力衰竭治疗中的利用不足

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摘要

Acute heart failure (AHF) is a growing public health concern with high inhospital mortality and costs. Clinical practice guidelines, underpinned by positive randomized controlled trials, recommend the early use of intravenous (IV) nitrates in the treatment of AHF. However, the real-world usage of IV nitrates has not been clearly defined. The objective of this study was to examine the use of IV nitrates in the treatment of AHF as recommended by clinical practice guidelines. A case-record analysis was conducted of all admissions with AHF at a large teaching hospital. Of the 81 AHF patients (mean age 77 +/- 11, mean SBP 130 +/- 27mmHg) enrolled for this analysis, only 5 (6%) received IV nitrates at the time of AHF admission. Forty (49%, mean age 77 +/- 11, mean SBP 131 +/- 27mmHg) of these 81 patients met the guideline criteria for suitability for IV nitrates and only 5 (12%) of these received them during this admission. Patients who received IV nitrates were more likely to have higher blood pressure and all had myocardial ischemia as a precipitant. Seventy-five (93%) of the total population received loop diuretics on admission. Overall, this study shows that loop diuretics remain the first-line therapy in AHF with little use of IV nitrates, despite recommendations from clinical practice guidelines.
机译：急性心力衰竭（AHF）是引起公众日益关注的公共卫生问题，其住院死亡率高且成本高。在积极的随机对照试验的支持下，临床实践指南建议尽早使用静脉内硝酸盐治疗AHF。但是，尚未明确定义IV硝酸盐在现实世界中的用法。这项研究的目的是按照临床实践指南的建议，检查IV硝酸盐在治疗AHF中的用途。在一家大型教学医院对所有AHF入院者进行了病例记录分析。在该分析纳入的81名AHF患者（平均年龄77 +/- 11，平均SBP 130 +/- 27mmHg）中，只有5例（6％）在AHF入院时接受了静脉硝酸盐治疗。这81名患者中有40名（49％，平均年龄77 +/- 11，平均SBP 131 +/- 27mmHg）符合IV硝酸盐适用性的指导标准，在入院期间只有5（12％）名患者接受了硝酸盐治疗。接受硝酸盐静脉注射的患者血压升高的可能性更高，并且所有患者都以心肌缺血为沉淀剂。总人口中有七十五（93％）人在入院时接受loop利尿剂治疗。总体而言，这项研究表明，尽管有临床实践指南的建议，但利尿剂仍是AHF的一线治疗，很少使用硝酸盐。

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