Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine.
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University.
Circ J. 2024 Oct 25;88(11):1727-1736. doi: 10.1253/circj.CJ-24-0633. Epub 2024 Sep 13.
In patients with acute myocardial infarction (MI), heart failure (HF) is one of the most common complications that is associated with a significant burden of mortality and healthcare resources. The clinical benefits of key HF drugs, the so-called "4 pillars" or "fantastic 4", namely β-blockers, mineralocorticoid receptor antagonists, angiotensin receptor-neprilysin inhibitor, and sodium-glucose cotransporter 2 inhibitors, have been established in patients with HF with reduced ejection fraction, whereas the effects of these drugs are not comprehensively appreciated in patients with acute MI. This review summarizes current evidence on pharmacological and device-based interventions for preventing HF after acute MI.
在急性心肌梗死(MI)患者中,心力衰竭(HF)是最常见的并发症之一,与死亡率和医疗资源的巨大负担相关。心力衰竭的所谓“四大基石”或“神奇四药”,即β受体阻滞剂、盐皮质激素受体拮抗剂、血管紧张素受体-脑啡肽酶抑制剂和钠-葡萄糖共转运蛋白 2 抑制剂等关键 HF 药物的临床获益已在射血分数降低的心力衰竭患者中得到证实,而这些药物在急性 MI 患者中的作用尚未得到全面认识。本综述总结了预防急性 MI 后 HF 的药物和器械干预的现有证据。