Objective To assess the clinical efficacy and safety of salkubatrol/valsartan in combination with coenzyme Q10 in patients with chronic heart failure. Methods A total of 103 patients diagnosed with chronic heart failure in the Department of Cardiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology were included and randomly divided into two groups according to a random number table.Patients in treatment group were given salkubatrol/valsartan and coenzyme Q10 on the basis of conventional treatment,while patients in control group were given salkubatrol/valsartan only on the basis of conventional treatment.We analyzed and assessed several items in all patients before and after treatment for 12 weeks,including clinical symptoms,serum N-terminal brain natriuretic peptide (NT-proBNP),cardiac function classification,alanine aminotransferase (ALT),glomerular filtration rate (eGFR),serum potassium,serum creatinine (Scr),left ventricular end diastolic diameter (LVEDD),left ventricular ejection fraction (LVEF),average hospitalization time and 30 day readmission rate. Results After 12-week treatment,patients in treatment group showed notable improvement in the aspects of clinical symptoms and cardiac function classification when compared with control group.The total effective rate in treatment group (86.54%) was also higher than that in control group (64.71%),which showed a significant statistical difference.In comparison with control group,patients in treatment group had lower levels of NT-proBNP [(1382.92±1160.75) pg·mL-1vs(1978.19±1532.83) pg·mL-1],LVEDD [(57.32±9.72) mm vs(61.32±9.11) mm],ALT [(18.58±14.29) U·L-1vs(22.37±14.40) U·L-1],and blood creatinine [(72.13±31.58) μmol·L-1vs(86.29±26.53) μmol·L-1] after treatment,and the differences were statistically significant (P<0.05); However,patients in treatment group had higher levels of eGFR [(87.50±19.75) mL·min-1·(1.73 m2)-1vs(73.27±19.77) mL·min-1·(1.73 m2)-1] and LVEF [(38.63±12.84)% vs(34.02±8.93) %] than that in control group after treatment,and the differences were statistically significant (P<0.05). Conclusion The clinical efficacy of salkubatrol/valsartan combined with coenzyme Q10 in patients with chronic heart failure is remarkable.In the chronic heart failure context,the combination treatment of salkubatrol/valsartan with coenzyme Q10 can significantly reduce NT-proBNP content with notable improvement on cardiac function and little adverse effect on renel function,indicating the good safety of the combination treatment.
根据患者用药前后临床症状、心功能(New York Heart Association,NYHA)分级进行评估。显效:治疗12周后症状显著改善,NYHA心功能分级达到I级或提升2级;有效:治疗12周后症状改善,NYHA心功能分级提升1级;无效:治疗12周后症状无改善,NYHA心功能分级无明显变化;恶化:治疗12周后症状较治疗前加重,NYHA心功能分级降低≥1级。总有效率(%)=[(显效例数+有效例数)/总例数]×100%。
表2
两组患者治疗12周后临床症状和NYHA心功能分级改善情况
Tab.2
Improvement of clinical symptoms and NYHA cardiac function classification after 12 weeks of treatment in two groups of patients
组别
例数
显效
有效
恶化
无效
总有效
例
%
例
%
例
%
例
%
例
%
对照组
51
12
23.53
21
41.18
6
11.76
12
23.53
33
64.71
治疗组
52
23
44.23
22
42.31
2
3.85
5
9.61
45
86.54
表2
两组患者治疗12周后临床症状和NYHA心功能分级改善情况
Tab.2
Improvement of clinical symptoms and NYHA cardiac function classification after 12 weeks of treatment in two groups of patients
表3
两组患者治疗12周后NT-proBNP、LVEDD、LVEF比较
Tab.3
Comparison of NTproBNP,LVEDD and LVEF between the two groups of patients after 12 weeks of treatment $\bar{x}±s$
组别
例数
NT-proBNP/ (pg·mL-1)
LVEDD/ mm
LVEF/ %
对照组
51
1978.19±1532.83
61.32±9.11
34.02±8.93
治疗组
52
1382.92±1160.75
57.32±9.72
38.63±12.84
t
-2.206
-4.850
2.246
P
0.032
0.000
0.029
表3
两组患者治疗12周后NT-proBNP、LVEDD、LVEF比较
Tab.3
Comparison of NTproBNP,LVEDD and LVEF between the two groups of patients after 12 weeks of treatment $\bar{x}±s$
BUI AL,HORWICH TB,FONAROW GC.Epidemiology and risk profile of heart failure[J].Nat Rev Cardiol,2011,8(1):30-41.
Heart failure (HF) is a major public health issue, with a prevalence of over 5.8 million in the USA, and over 23 million worldwide, and rising. The lifetime risk of developing HF is one in five. Although promising evidence shows that the age-adjusted incidence of HF may have plateaued, HF still carries substantial morbidity and mortality, with 5-year mortality that rival those of many cancers. HF represents a considerable burden to the health-care system, responsible for costs of more than $39 billion annually in the USA alone, and high rates of hospitalizations, readmissions, and outpatient visits. HF is not a single entity, but a clinical syndrome that may have different characteristics depending on age, sex, race or ethnicity, left ventricular ejection fraction (LVEF) status, and HF etiology. Furthermore, pathophysiological differences are observed among patients diagnosed with HF and reduced LVEF compared with HF and preserved LVEF, which are beginning to be better appreciated in epidemiological studies. A number of risk factors, such as ischemic heart disease, hypertension, smoking, obesity, and diabetes, among others, have been identified that both predict the incidence of HF as well as its severity. In this Review, we discuss key features of the epidemiology and risk profile of HF.
SOLOMON SD,CLAGGETTB,DESAI AS,et al.Influence of ejection fraction on outcomes and efficacy of sacubitril/valsartan (LCZ696) in heart failure with reduced ejection fraction:the prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure (PARADIGM-HF) trial[J].Circ Heart Fail,2016,9(3):e2744.
[本文引用:1]
[6]
SHARMAA,FONAROW GC,BUTLERJ,et al.Coenzyme Q10 and heart failure: a state-of-the-art review[J].Circ Heart Fail,2016,9(4):e2639.
[本文引用:1]
[7]
MORTENSEN SA,ROSENFELDTF,KUMARA,et al.The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure:results from Q-SYMBIO:a randomized double-blind trial[J].JACC Heart Fail,2014,2(6):641-649.
OBJECTIVES: This randomized controlled multicenter trial evaluated coenzyme Q10 (CoQ10) as adjunctive treatment in chronic heart failure (HF). BACKGROUND: CoQ10 is an essential cofactor for energy production and is also a powerful antioxidant. A low level of myocardial CoQ10 is related to the severity of HF. Previous randomized controlled trials of CoQ10 in HF were underpowered to address major clinical endpoints. METHODS: Patients with moderate to severe HF were randomly assigned in a 2-year prospective trial to either CoQ10 100 mg 3 times daily or placebo, in addition to standard therapy. The primary short-term endpoints at 16 weeks were changes in New York Heart Association (NYHA) functional classification, 6-min walk test, and levels of N-terminal pro-B type natriuretic peptide. The primary long-term endpoint at 2 years was composite major adverse cardiovascular events as determined by a time to first event analysis. RESULTS: A total of 420 patients were enrolled. There were no significant changes in short-term endpoints. The primary long-term endpoint was reached by 15% of the patients in the CoQ10 group versus 26% in the placebo group (hazard ratio: 0.50; 95% confidence interval: 0.32 to 0.80; p = 0.003) by intention-to-treat analysis. The following secondary endpoints were significantly lower in the CoQ10 group compared with the placebo group: cardiovascular mortality (9% vs. 16%, p = 0.026), all-cause mortality (10% vs. 18%, p = 0.018), and incidence of hospital stays for HF (p = 0.033). In addition, a significant improvement of NYHA class was found in the CoQ10 group after 2 years (p = 0.028). CONCLUSIONS: Long-term CoQ10 treatment of patients with chronic HF is safe, improves symptoms, and reduces major adverse cardiovascular events. (Coenzyme Q10 as adjunctive treatment of chronic heart failure: a randomised, double-blind, multicentre trial with focus on SYMptoms, BIomarker status [Brain-Natriuretic Peptide (BNP)], and long-term Outcome [hospitalisations/mortality]; ISRCTN94506234).
WWCHTERR,SENNIM,BELOHLAVEKJ,et al.Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study[J].Eur J Heart Fail,2019,21(8):998-1007.
SOLOMON SD,RIZKALA AR,GONGJ,et al.Angiotensin receptor neprilysin inhibition in heart failure with preserved ejection fraction: rationale and design of the PARAGON-HF trial[J].JACC Heart Fail,2017,5(7):471-482.
THOMASM,KHARITONY,FONAROW GC,et al.Association of changes in heart failure treatment with patients' health status: real-world evidence from CHAMP-HF[J].JACC Heart Fail,2019,7(7):615-625.
OBJECTIVES: The aim of this study was to use a multicenter, observational outpatient registry of patients with heart failure with reduced ejection fraction (HFrEF) to describe the association between changes in patients' medications with changes in health status. BACKGROUND: Alleviating symptoms and improving function and quality of life for patients with HFrEF are primary treatment goals and potential indicators of quality. Whether titrating medications in routine clinical care improves patients' health status is unknown. METHODS: The association of any change in HFrEF medications with 3-month change in health status, as measured using the 12-item Kansas City Cardiomyopathy Questionnaire Overall Summary Scale, was determined in unadjusted and multivariate-adjusted (25 clinical characteristics, baseline health status) models using hierarchical linear regression. RESULTS: Among 3,313 outpatients with HFrEF from 140 centers, 21.9% had medication changes. Three months later, 23.7% and 46.4% had clinically meaningfully worse (>/=5-point decrease) and improved (>/=5-point increase) Kansas City Cardiomyopathy Questionnaire Overall Summary Scale scores. The 3-month median change in Kansas City Cardiomyopathy Questionnaire Overall Summary Scale score for patients whose HFrEF medications were changed was significantly larger (7.3 points; interquartile range: -3.1 to 20.8 points) than in patients whose medications were not changed (3.1 points; interquartile range: -4.7 to 12.5 points) (adjusted difference 3.0 points; 95% confidence interval: 1.4 to 4.6 points; p < 0.001). Among patients whose medications were adjusted, 26% had very large clinical improvement (>/=20 points) compared with 14% whose regimens were not changed. CONCLUSIONS: In routine care of patients with HFrEF, changes in HFrEF medications were associated with significant improvements in patients' health status, suggesting that health status-based performance measures can quantify the benefits of titrating medicines in patients with HFrEF.
YANCY CW,JESSUPM,BOZKURTB,et al.2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: A report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart failure society of America[J].Circulation,2017,136(6):e137-e161.
PONIKOWSKIP,VOORS AA,ANKER SD,et al.2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[J].Eur Heart J,2016,37(27):2129-2200.
JANKOWSKIJ,KORZENIOWSKAK,CIESLEWICZA,et al.Coenzyme Q10 -A new player in the treatment of heart failure?[J].Pharmacol Rep,2016,68(5):1015-1019.
Coenzyme Q10 is the only endogenously synthesized lipid with a redox function which exhibits broad tissue and intracellular distribution in mammals. Beneficial effects of Coenzyme Q10 supplementation were observed in several age-related diseases including heart failure. CoQ10 (coenzyme Q10) level is significantly decreased in patients with this disease, which correlates with severity of clinical symptoms. Supplementation with various pharmaceutical formulations of CoQ10 improves impaired cardiac function and clinical course of heart failure. Current data from clinical trials indicate that CoQ10 can significantly reduce morbidity and mortality of heart failure patients in addition to guideline recommended pharmacotherapy.
DESAI AS,CLAGGETT BL,PACKERM,et al.Influence of sacubitril/valsartan (LCZ696) on 30-day readmission after heart failure hospitalization[J].J Am Coll Cardiol,2016,68(3):241-248.
BACKGROUND: Patients with heart failure (HF) are at high risk for hospital readmission in the first 30 days following HF hospitalization. OBJECTIVES: This study sought to determine if treatment with sacubitril/valsartan (LCZ696) reduces rates of hospital readmission at 30-days following HF hospitalization compared with enalapril. METHODS: We assessed the risk of 30-day readmission for any cause following investigator-reported hospitalizations for HF in the PARADIGM-HF trial, which randomized 8,399 participants with HF and reduced ejection fraction to treatment with LCZ696 or enalapril. RESULTS: Accounting for multiple hospitalizations per patient, there were 2,383 investigator-reported HF hospitalizations, of which 1,076 (45.2%) occurred in subjects assigned to LCZ696 and 1,307 (54.8%) occurred in subjects assigned to enalapril. Rates of readmission for any cause at 30 days were 17.8% in LCZ696-assigned subjects and 21.0% in enalapril-assigned subjects (odds ratio: 0.74; 95% confidence interval: 0.56 to 0.97; p = 0.031). Rates of readmission for HF at 30-days were also lower in subjects assigned to LCZ696 (9.7% vs. 13.4%; odds ratio: 0.62; 95% confidence interval: 0.45 to 0.87; p = 0.006). The reduction in both all-cause and HF readmissions with LCZ696 was maintained when the time window from discharge was extended to 60 days and in sensitivity analyses restricted to adjudicated HF hospitalizations. CONCLUSIONS: Compared with enalapril, treatment with LCZ696 reduces 30-day readmissions for any cause following discharge from HF hospitalization.
Influence of ejection fraction on outcomes and efficacy of sacubitril/valsartan (LCZ696) in heart failure with reduced ejection fraction:the prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure (PARADIGM-HF) trial
... 沙库巴曲缬沙坦可同时抑制RAAS系统并调节利钠肽系统.多项大型研究表明,不管是射血分数减少型心衰(heart failure reduced with ejection fraction,HFrEF)还是射血分数保留型心衰(heart failure preserved with ejection fraction,HFpEF)患者,沙库巴曲缬沙坦均能使其在降低心血管死亡、心衰住院风险以及再住院率,改善心衰患者症状、生活质量、日常活动限制等方面获益[8,9,10,11].同时,国内外多个指南也推荐沙库巴曲缬沙坦为心衰治疗的基石药物,2018中国心力衰竭诊断和治疗指南将沙库巴曲缬沙坦推荐为Ⅰ类,B级证据[1];2017美国心脏病学会/美国心脏协会/美国心衰学会心力衰竭管理指南将沙库巴曲缬沙坦推荐为Ⅰ类,B-R级证据[12];2016年欧洲心脏病学会心衰指南将沙库巴曲缬沙坦推荐为I类,B级证据[13].辅酶Q10作为一种心衰辅助用药,目前在临床得到广泛应用.有研究表明,辅酶Q10的缺乏与心力衰竭严重程度相关[14],长期应用辅酶Q10可改善心衰患者的临床症状、心功能分级,减少不良心血管事件的发生且安全可靠[7]. ...
Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study
1
2019
... 沙库巴曲缬沙坦可同时抑制RAAS系统并调节利钠肽系统.多项大型研究表明,不管是射血分数减少型心衰(heart failure reduced with ejection fraction,HFrEF)还是射血分数保留型心衰(heart failure preserved with ejection fraction,HFpEF)患者,沙库巴曲缬沙坦均能使其在降低心血管死亡、心衰住院风险以及再住院率,改善心衰患者症状、生活质量、日常活动限制等方面获益[8,9,10,11].同时,国内外多个指南也推荐沙库巴曲缬沙坦为心衰治疗的基石药物,2018中国心力衰竭诊断和治疗指南将沙库巴曲缬沙坦推荐为Ⅰ类,B级证据[1];2017美国心脏病学会/美国心脏协会/美国心衰学会心力衰竭管理指南将沙库巴曲缬沙坦推荐为Ⅰ类,B-R级证据[12];2016年欧洲心脏病学会心衰指南将沙库巴曲缬沙坦推荐为I类,B级证据[13].辅酶Q10作为一种心衰辅助用药,目前在临床得到广泛应用.有研究表明,辅酶Q10的缺乏与心力衰竭严重程度相关[14],长期应用辅酶Q10可改善心衰患者的临床症状、心功能分级,减少不良心血管事件的发生且安全可靠[7]. ...
Angiotensin receptor neprilysin inhibition in heart failure with preserved ejection fraction: rationale and design of the PARAGON-HF trial
1
2017
... 沙库巴曲缬沙坦可同时抑制RAAS系统并调节利钠肽系统.多项大型研究表明,不管是射血分数减少型心衰(heart failure reduced with ejection fraction,HFrEF)还是射血分数保留型心衰(heart failure preserved with ejection fraction,HFpEF)患者,沙库巴曲缬沙坦均能使其在降低心血管死亡、心衰住院风险以及再住院率,改善心衰患者症状、生活质量、日常活动限制等方面获益[8,9,10,11].同时,国内外多个指南也推荐沙库巴曲缬沙坦为心衰治疗的基石药物,2018中国心力衰竭诊断和治疗指南将沙库巴曲缬沙坦推荐为Ⅰ类,B级证据[1];2017美国心脏病学会/美国心脏协会/美国心衰学会心力衰竭管理指南将沙库巴曲缬沙坦推荐为Ⅰ类,B-R级证据[12];2016年欧洲心脏病学会心衰指南将沙库巴曲缬沙坦推荐为I类,B级证据[13].辅酶Q10作为一种心衰辅助用药,目前在临床得到广泛应用.有研究表明,辅酶Q10的缺乏与心力衰竭严重程度相关[14],长期应用辅酶Q10可改善心衰患者的临床症状、心功能分级,减少不良心血管事件的发生且安全可靠[7]. ...
Association of changes in heart failure treatment with patients' health status: real-world evidence from CHAMP-HF
1
2019
... 沙库巴曲缬沙坦可同时抑制RAAS系统并调节利钠肽系统.多项大型研究表明,不管是射血分数减少型心衰(heart failure reduced with ejection fraction,HFrEF)还是射血分数保留型心衰(heart failure preserved with ejection fraction,HFpEF)患者,沙库巴曲缬沙坦均能使其在降低心血管死亡、心衰住院风险以及再住院率,改善心衰患者症状、生活质量、日常活动限制等方面获益[8,9,10,11].同时,国内外多个指南也推荐沙库巴曲缬沙坦为心衰治疗的基石药物,2018中国心力衰竭诊断和治疗指南将沙库巴曲缬沙坦推荐为Ⅰ类,B级证据[1];2017美国心脏病学会/美国心脏协会/美国心衰学会心力衰竭管理指南将沙库巴曲缬沙坦推荐为Ⅰ类,B-R级证据[12];2016年欧洲心脏病学会心衰指南将沙库巴曲缬沙坦推荐为I类,B级证据[13].辅酶Q10作为一种心衰辅助用药,目前在临床得到广泛应用.有研究表明,辅酶Q10的缺乏与心力衰竭严重程度相关[14],长期应用辅酶Q10可改善心衰患者的临床症状、心功能分级,减少不良心血管事件的发生且安全可靠[7]. ...
《中国心力衰竭诊断和治疗指南2018》药物更新透视
1
2019
... 沙库巴曲缬沙坦可同时抑制RAAS系统并调节利钠肽系统.多项大型研究表明,不管是射血分数减少型心衰(heart failure reduced with ejection fraction,HFrEF)还是射血分数保留型心衰(heart failure preserved with ejection fraction,HFpEF)患者,沙库巴曲缬沙坦均能使其在降低心血管死亡、心衰住院风险以及再住院率,改善心衰患者症状、生活质量、日常活动限制等方面获益[8,9,10,11].同时,国内外多个指南也推荐沙库巴曲缬沙坦为心衰治疗的基石药物,2018中国心力衰竭诊断和治疗指南将沙库巴曲缬沙坦推荐为Ⅰ类,B级证据[1];2017美国心脏病学会/美国心脏协会/美国心衰学会心力衰竭管理指南将沙库巴曲缬沙坦推荐为Ⅰ类,B-R级证据[12];2016年欧洲心脏病学会心衰指南将沙库巴曲缬沙坦推荐为I类,B级证据[13].辅酶Q10作为一种心衰辅助用药,目前在临床得到广泛应用.有研究表明,辅酶Q10的缺乏与心力衰竭严重程度相关[14],长期应用辅酶Q10可改善心衰患者的临床症状、心功能分级,减少不良心血管事件的发生且安全可靠[7]. ...
2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: A report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart failure society of America
1
2017
... 沙库巴曲缬沙坦可同时抑制RAAS系统并调节利钠肽系统.多项大型研究表明,不管是射血分数减少型心衰(heart failure reduced with ejection fraction,HFrEF)还是射血分数保留型心衰(heart failure preserved with ejection fraction,HFpEF)患者,沙库巴曲缬沙坦均能使其在降低心血管死亡、心衰住院风险以及再住院率,改善心衰患者症状、生活质量、日常活动限制等方面获益[8,9,10,11].同时,国内外多个指南也推荐沙库巴曲缬沙坦为心衰治疗的基石药物,2018中国心力衰竭诊断和治疗指南将沙库巴曲缬沙坦推荐为Ⅰ类,B级证据[1];2017美国心脏病学会/美国心脏协会/美国心衰学会心力衰竭管理指南将沙库巴曲缬沙坦推荐为Ⅰ类,B-R级证据[12];2016年欧洲心脏病学会心衰指南将沙库巴曲缬沙坦推荐为I类,B级证据[13].辅酶Q10作为一种心衰辅助用药,目前在临床得到广泛应用.有研究表明,辅酶Q10的缺乏与心力衰竭严重程度相关[14],长期应用辅酶Q10可改善心衰患者的临床症状、心功能分级,减少不良心血管事件的发生且安全可靠[7]. ...
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC
1
2016
... 沙库巴曲缬沙坦可同时抑制RAAS系统并调节利钠肽系统.多项大型研究表明,不管是射血分数减少型心衰(heart failure reduced with ejection fraction,HFrEF)还是射血分数保留型心衰(heart failure preserved with ejection fraction,HFpEF)患者,沙库巴曲缬沙坦均能使其在降低心血管死亡、心衰住院风险以及再住院率,改善心衰患者症状、生活质量、日常活动限制等方面获益[8,9,10,11].同时,国内外多个指南也推荐沙库巴曲缬沙坦为心衰治疗的基石药物,2018中国心力衰竭诊断和治疗指南将沙库巴曲缬沙坦推荐为Ⅰ类,B级证据[1];2017美国心脏病学会/美国心脏协会/美国心衰学会心力衰竭管理指南将沙库巴曲缬沙坦推荐为Ⅰ类,B-R级证据[12];2016年欧洲心脏病学会心衰指南将沙库巴曲缬沙坦推荐为I类,B级证据[13].辅酶Q10作为一种心衰辅助用药,目前在临床得到广泛应用.有研究表明,辅酶Q10的缺乏与心力衰竭严重程度相关[14],长期应用辅酶Q10可改善心衰患者的临床症状、心功能分级,减少不良心血管事件的发生且安全可靠[7]. ...
Coenzyme Q10 -A new player in the treatment of heart failure?
1
2016
... 沙库巴曲缬沙坦可同时抑制RAAS系统并调节利钠肽系统.多项大型研究表明,不管是射血分数减少型心衰(heart failure reduced with ejection fraction,HFrEF)还是射血分数保留型心衰(heart failure preserved with ejection fraction,HFpEF)患者,沙库巴曲缬沙坦均能使其在降低心血管死亡、心衰住院风险以及再住院率,改善心衰患者症状、生活质量、日常活动限制等方面获益[8,9,10,11].同时,国内外多个指南也推荐沙库巴曲缬沙坦为心衰治疗的基石药物,2018中国心力衰竭诊断和治疗指南将沙库巴曲缬沙坦推荐为Ⅰ类,B级证据[1];2017美国心脏病学会/美国心脏协会/美国心衰学会心力衰竭管理指南将沙库巴曲缬沙坦推荐为Ⅰ类,B-R级证据[12];2016年欧洲心脏病学会心衰指南将沙库巴曲缬沙坦推荐为I类,B级证据[13].辅酶Q10作为一种心衰辅助用药,目前在临床得到广泛应用.有研究表明,辅酶Q10的缺乏与心力衰竭严重程度相关[14],长期应用辅酶Q10可改善心衰患者的临床症状、心功能分级,减少不良心血管事件的发生且安全可靠[7]. ...
Influence of sacubitril/valsartan (LCZ696) on 30-day readmission after heart failure hospitalization
, 覃雅婷
