课件：心力衰竭的药物与辅助装置治疗阜外心血管病医院张健.ppt

* * * * * * * * * * * * * * * * * * * * * * * 结 论 96 h时药物治疗在保存肾功能方面优于超滤，同时体重下降幅度相似。 本研究中所采用的超滤不良事件发生率更高，因此对于肾功能恶化的持续充血的ADHF患者较阶梯式药物治疗没有优势。 此类患者的治疗仍是有挑战的临床问题，需要有更好的治疗手段。 Thank You! * THANK YOU SUCCESS * * 可编辑 * * * * * * no significant differences in 22 variables among the 3 Rx groups) * * * * * * 1. Describe the difference between the primary HF morbidity objective and the secondary HF hospitalization in that for the primary, the patient must have presented with HF symptoms in which IV diuretics or in which was classified as meeting the primary objective even if HF wasn’t the primary reason for the hospitalization, but later developed HF and given IV diuretics while being hospitalized. The secondary objective hospitalization was met if the patient was admitted for HF and may or may not have received IV therapies * You might want to comment that a brief summary of why a Bayesian approach was chosen and how to interpret the data via Bayesian methods will be described in an upcoming slide. * DMC recommended trial be continued at least through October 15; Data in presentation is data through September 24, 2012 (data cleaned and frozen on Oct 15). The medications are bolded showing consistency across both groups at Randomization versus at Baseline. * Key Take-Away: There was demonstrated to be at least a 10% relative reduction in risk (95% upper bound for HR is 0.9) and an estimated 26% relative reduction (estimated HR is 0.74) in mortality/HF urgent care risk and significant increase in left ventricular volume in the BiV arm versus the RV arm. This finding holds up in the CRT-P subjects alone as well. In the CRT-D subjects, the HR estimate was comparable to that of the CRT-P subjects, as were the BiV and RV event rates themselves (see next slide). * Graphs show the composite primary objective without the echo endpoint for both types of devices. Even without LVESVi, we passed. These results demonstrate at least a 19% relative reduction in mortality/HF urge