药物治疗心衰并慢性肾脏病患者的疗效及安全性

药物治疗心衰并慢性肾脏病患者的疗效及安全性第1页/共17页ContentsAimMethodsandResultsConclusion第2页/共17页AIMMineralocorticoidreceptorantagonists(MRAs)improveoutcomesinpatientswithheartfailureandreducedleftventricularejectionfraction(HFrEF),buttheiruseislimitedbyhyperkalaemiaand/orworseningrenalfunction(WRF).BAY94-8862isahighlyselectiveandstronglypotentnon-steroidalMRA.WeinvestigateditssafetyandtolerabilityinBAY94-8862isahighlyselectiveandstronglypotentnon-steroidalMRA.WeinvestigateditssafetyandtolerabilityinpatientswithHFrEFassociatedwithmildormoderatechronickidneydisease(CKD).第3页/共17页Methodsandresults

Thisrandomized,controlled,phaseIItrialconsistedoftwoparts.InpartA,thesafetyandtolerabilityoforalBAY94-8862[2.5,5,or10mgoncedaily(q.d.)]wasassessedin65patientswithHFrEFandmildCKD.InpartB,BAY94-8862(2.5,5,or10mgq.d.,or5mgtwicedaily)wascomparedwithplaceboandopen-labelspironolactone(25or50mg/day)in392patientswithHFrEFandmoderateCKD.第4页/共17页ResultsBAY94-8862wasassociatedwithsignificantlysmallermeanincreasesinserumpotassiumconcentrationthanspironolactone(0.04–0.30and0.45mmol/L,respectively,P<0.0001–0.0107)andlowerincidencesofhyperkalaemia(5.3and12.7%,respectively,P=0.048)andWRF.第5页/共17页ResultsBAY94-8862decreasedthelevelsofB-typenatriureticpeptide(BNP),amino-terminalproBNP,andalbuminuriaatleastasmuchasspironolactone.AdverseeventsrelatedtoBAY94-8862wereinfrequentandmostlymild.第6页/共17页ConclusionInpatientswithHFrEFandmoderateCKD,BAY94-88625–10mg/daywasatleastaseffectiveasspironolactone25or50mg/dayindecreasingbiomarkersofhaemodynamicstress,butitwasassociatedwithlowerincidencesofhyperkalaemiaandWRF.第7页/共17页第8页/共17页第9页/共17页第10页/共17页第11页/共17页第12页/共