地高辛:系统回顾在心房纤颤,充血性心力衰竭和心肌梗死。

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Virgadamo年代,Charnigo R, Darrat Y,莫拉莱斯G, Elayi CS

地高辛:系统回顾在心房纤颤,充血性心力衰竭和心肌梗死。

世界心功能杂志。2015年11月26日,7 (11):808 - 16。doi: 10.4330 / wjc.v7.i11.808。

PubMed ID

26635929 (在PubMed

]

文摘

目的:回顾使用地高辛收缩期充血性心力衰竭、房颤,心肌梗死后。方法:综合PubMed搜索使用关键字进行“地高辛和充血性心力衰竭必威国际app”,“地高辛和心房纤维性颤动”,“地高辛、心房颤动和收缩期充血性心力衰竭”,和“地高辛和心肌梗塞”。只有用英语写文章纳入本研究。我们保留来自随机对照试验的研究,注册中心和包括至少500名患者。研究包括心房纤颤患者心力衰竭或心肌梗死,很大一部分患者的地高辛(至少5%)。表审查不同的风险比率是根据选定的文章。我们主要终点是患者的总死亡率地高辛和那些没有地高辛,房颤患者也在房颤患者和收缩期心力衰竭。我们回顾了最近的国际准则,讨论当前的建议。结果:总共有18项研究发现,地高辛和总体死亡率评估在不同的临床设置包括收缩期充血性心力衰竭和正常窦性心律(n = 5),心房纤维性颤动有或没有收缩充血性心力衰竭(n = 9),和心肌梗死(n = 4)。总的来说,患者收缩压正常窦性心律的充血性心力衰竭,地高辛似乎中性影响死亡率尤其是密切监测采用地高辛水平。然而,大多数的观察性研究评估使用地高辛心房纤维性颤动没有收缩充血性心力衰竭服用地高辛时显示整体死亡率的增加。 In the studies evaluated in this systematic review, the data among patients with atrial fibrillation and systolic congestive heart failure, as well as post myocardial infarction were more controversial. The extent to which discrepancies among studies are based on statistical methods is currently unclear, as these studies' findings are generated by retrospective analyses that employed different techniques to address confounding. CONCLUSION: Based on the potential risks and benefits, as well as the presence of alternative drugs, there is a limited role for digoxin in the management of patients with normal sinus rhythm and congestive heart failure. Based on the retrospective studies reviewed there is a growing volume of data showing increased mortality in those with only atrial fibrillation. The proper role of digoxin is, however, less certain in other subgroups of patients, such as those with both atrial fibrillation and systolic congestive heart failure or after a myocardial infarction. Further studies may provide helpful information for such subgroups of patients.

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地高辛