药物治疗心衰并慢性肾脏病患者的疗效及安全性.pptx

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1、LOGO新型盐皮质受体拮抗剂治疗心衰并慢性新型盐皮质受体拮抗剂治疗心衰并慢性新型盐皮质受体拮抗剂治疗心衰并慢性新型盐皮质受体拮抗剂治疗心衰并慢性肾脏病患者的疗效及安全性肾脏病患者的疗效及安全性肾脏病患者的疗效及安全性肾脏病患者的疗效及安全性20132013European Heart Journal(2013)34,24532463LOGOContentsContentsAimMethods and ResultsConclusionAIMAIMvMineralocorticoid receptor antagonists(MRAs)improve outcomes in patients w

2、ith heart failure and reduced left ventricular ejection fraction(HFrEF),but their use is limited by hyperkalaemia and/or worsening renal function(WRF).vBAY 94-8862 is a highly selective and strongly potent non-steroidal MRA.vWe investigated its safety and tolerability in BAY 94-8862 is a highly sele

3、ctive and strongly potent non-steroidal MRA.We investigated its safety and tolerability in patients with HFrEF associated with mild or moderate chronic kidney disease(CKD).LOGOMethods and resultsMethods and resultsvThis randomized,controlled,phase II trial consisted of two parts.vIn part A,the safet

4、y and tolerability of oral BAY 94-88622.5,5,or 10 mg once daily(q.d.)was assessed in 65 patients with HFrEF and mild CKD.vIn part B,BAY 94-8862(2.5,5,or 10 mg q.d.,or 5 mg twice daily)was compared with placebo and open-label spironolactone(25 or 50 mg/day)in 392 patients with HFrEF and moderate CKD.

5、LOGOResultsResultsvBAY 94-8862 was associated with significantly smaller mean increases in serum potassium concentration than spironolactone(0.040.30 and 0.45 mmol/L,respectively,P0.00010.0107)and lower incidences of hyperkalaemia(5.3 and 12.7%,respectively,P=0.048)and WRF.LOGOResultsResultsvBAY 94-

6、8862 decreased the levels of B-type natriuretic peptide(BNP),amino-terminal proBNP,and albuminuria at least as much as spironolactone.vAdverse events related to BAY 94-8862 were infrequent and mostly mild.LOGOConclusionConclusionvIn patients with HFrEF and moderate CKD,BAY 94-8862 510 mg/day was at least as effective as spironolactone 25 or 50 mg/day in decreasing biomarkers of haemodynamic stress,but it was associated with lower incidences of hyperkalaemia and WRF.LOGOLOGOLOGOLOGOLOGOLOGOLOGOLOGOLOGOLOGO