万爽力在心衰患者的临床获益课件.ppt

小 结 心力衰竭严重影响人类健康 联合万爽力?全面优化心衰治疗 减轻症状，提高生活质量 改善左室功能，降低死亡率 研究证实可以获益的心功能不全人群 稳定性冠心病合并心功能不全 缺血性心肌病 特发性扩张性心肌病 谢 谢 20mg 一天三次 * * 随着冠心病治疗手段的日新月异，冠心病死亡率逐渐降低。图为《美国心血管疾病/脑卒中统计年鉴2010》，左边为冠心病患者死亡率，即从上世纪80年代至2006年，冠心病年死亡人数已降至450/千人以下，女性略高于男性；但出院患者心力衰竭发病率却逐年增加，而且增势非常稳定。由此可见心力衰竭已成为目前心血管治疗中亟待解决的问题。 * 重组B型钠尿肽（奈西利肽）作为治疗药物静脉给药处置已经证明可以最佳化ADHF治疗的风险/收益率。 * 摘要 Abstract Objective—To describe the survival of a population based cohort of patients with incident (new) heart failure and the clinical features associated with mortality. Design—A population based observational study. Setting—Population of 151 000 served by 82 general practitioners in west London. Patients—New cases of heart failure were identified by daily surveillance of acute hospital admissions to the local district general hospital, and by general practitioner referral of all suspected new cases of heart failure to a rapid access clinic. Interventions—All patients with suspected heart failure underwent clinical assessment, and chest radiography, ECG, and echocardiogram were performed. A panel of three cardiologists reviewed all the data and determined whether the definition of heart failure had been met. Patients were subsequently managed by the general practitioner in consultation with the local cardiologist or admitting physician. Main outcome measures—Death, overall and from cardiovascular causes. Results—There were 90 deaths (83 cardiovascular deaths) in the cohort of 220 patients with incident heart failure over a median follow up of 16 months. Survival was 81% at one month, 75% at three months, 70% at six months, 62% at 12 months, and 57% at 18 months. Lower systolic blood pressure, higher serum creatinine concentration, and greater extent of crackles on auscultation of the lungs were independently predictive of cardiovascular mortality (all p 0.001). Conclusions—In patients with new heart failure, mortality is high in the first few weeks after diagnosis. Simple clinical features can identify a group of patients at