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Eur J Heart Fail：衰弱综合征与患者结局

2018-09-19 xing.T MedSci原创

衰弱综合征HFpEF结局
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由此可见，TOPCAT试验中HFpEF患者衰弱非常普遍。衰弱越严重与心血管结局和死亡率的高风险相关。螺内酯对TOPCAT结果的益处并未因衰弱程度而减弱。

既往随机的射血分数正常的心衰（HFpEF）试验从未报道过衰弱对患者结局的影响。近日，心血管领域权威杂志European Journal of Heart Failure上发表了一篇研究文章，该分析旨在归纳HFpEF临床试验队列中衰弱的特征，并评估其对患者相关结局的影响。

研究人员使用来自醛固酮拮抗剂治疗HFpEF（TOPCAT）试验的数据，并使用39个临床、实验室和自我报告的基线变量构建衰弱指数（FI）。研究人员在1767名TOPCAT患者的亚组中评估了衰弱和结局之间的关系以及衰弱在调节螺内酯的益处中的作用。

对于整个队列（平均年龄为71.5岁，49％为女性），基线平均FI为0.37±0.11。研究人员定义了四个衰弱组别，从FI<0.3到FI≥0.5。总体而言，94％的受试者被认为是虚弱的（定义为FI>0.21）。最衰弱受试者平均年龄最小（4级为69±9岁; 1级为73±10岁; P<0.001）。随着FI增加，体重指数、收缩压和脉压均增加。随着衰弱程度的增加，初级和次级结局均增加。衰弱程度与螺内酯的治疗效果之间没有相互作用。

由此可见，TOPCAT试验中HFpEF患者衰弱非常普遍。衰弱越严重与心血管结局和死亡率的高风险相关。螺内酯对TOPCAT结果的益处并未因衰弱程度而减弱。

原始出处：

Natalie A. Sanders, et al.The frailty syndrome and outcomes in the TOPCAT trial. European journal of heart failure. 2018. https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.1308

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    2021-03-05 苏小雨

    学习了，点赞

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    2018-09-23 lietome2

    好文，值得点赞！认真学习了，把经验应用于实践，为患者解除病痛。

    0

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    2018-09-23 lietome24

    好文，值得点赞！认真学习，应用于实践！谢谢分享给广大同好！

    0

  4. 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01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431328, encodeId=762b14313287b, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Sep 21 01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480015, encodeId=fc5d148001592, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, 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channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Wed Sep 19 13:13:20 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345661, encodeId=deb034566103, content=好文，值得点赞！认真学习了，把经验应用于实践，为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Wed Sep 19 11:54:23 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345658, encodeId=27e8345658fa, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Sep 19 11:20:41 CST 2018, time=2018-09-19, status=1, ipAttribution=)]
    2018-09-21 zhaojie88

    #ART#

    0

  5. 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01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431328, encodeId=762b14313287b, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Sep 21 01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480015, encodeId=fc5d148001592, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, 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channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Wed Sep 19 13:13:20 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345661, encodeId=deb034566103, content=好文，值得点赞！认真学习了，把经验应用于实践，为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Wed Sep 19 11:54:23 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345658, encodeId=27e8345658fa, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Sep 19 11:20:41 CST 2018, time=2018-09-19, status=1, ipAttribution=)]
    2018-09-21 zhouqu_8

    #综合征#

    0

  6. 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01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431328, encodeId=762b14313287b, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Sep 21 01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480015, encodeId=fc5d148001592, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, 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channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Wed Sep 19 13:13:20 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345661, encodeId=deb034566103, content=好文，值得点赞！认真学习了，把经验应用于实践，为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Wed Sep 19 11:54:23 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345658, encodeId=27e8345658fa, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Sep 19 11:20:41 CST 2018, time=2018-09-19, status=1, ipAttribution=)]
    2018-09-21 ms5906905816781247

    #患者结局#

    0

  7. 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01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431328, encodeId=762b14313287b, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Sep 21 01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480015, encodeId=fc5d148001592, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, 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channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Wed Sep 19 13:13:20 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345661, encodeId=deb034566103, content=好文，值得点赞！认真学习了，把经验应用于实践，为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Wed Sep 19 11:54:23 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345658, encodeId=27e8345658fa, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Sep 19 11:20:41 CST 2018, time=2018-09-19, status=1, ipAttribution=)]
    2018-09-21 slcumt

    #HEART#

    0

  8. 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01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431328, encodeId=762b14313287b, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Sep 21 01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480015, encodeId=fc5d148001592, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, 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channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Wed Sep 19 13:13:20 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345661, encodeId=deb034566103, content=好文，值得点赞！认真学习了，把经验应用于实践，为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Wed Sep 19 11:54:23 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345658, encodeId=27e8345658fa, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Sep 19 11:20:41 CST 2018, time=2018-09-19, status=1, ipAttribution=)]
    2018-09-19 flysky120

    随着年龄的增长，衰弱综合征也要增加

    0

  9. 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01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431328, encodeId=762b14313287b, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Sep 21 01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480015, encodeId=fc5d148001592, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, 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encodeId=27e8345658fa, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Sep 19 11:20:41 CST 2018, time=2018-09-19, status=1, ipAttribution=)]
    2018-09-19 lietome2

    好文，值得点赞！认真学习了，把经验应用于实践，为患者解除病痛。

    0

  10. 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01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431328, encodeId=762b14313287b, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Sep 21 01:46:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480015, encodeId=fc5d148001592, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, 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channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Wed Sep 19 13:13:20 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345661, encodeId=deb034566103, content=好文，值得点赞！认真学习了，把经验应用于实践，为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Wed Sep 19 11:54:23 CST 2018, time=2018-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345658, encodeId=27e8345658fa, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed Sep 19 11:20:41 CST 2018, time=2018-09-19, status=1, ipAttribution=)]
    2018-09-19 易水河

    学习学习

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