[GWICC2009]ISCP主席Jay N. Cohn教授谈药物治疗和早期筛查干预 -国际循环网

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[GWICC2009]ISCP主席Jay N. Cohn教授谈药物治疗和早期筛查干预

作者:国际循环网日期:2009/10/14 17:27:00

International Circulation: ACE inhibitors and ARB have become the cornerstone of pharmacotherapy in heart failure management today. In A-HeFT trial， you showed a combination of isosorbide dinitrate with hydralazine achieved a better survival rate than placebo in African American population. Do you think to establish an optimal therapy for heart failure， we should integrate different methods which target independent mechanisms?《国际循环》: 血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体拮抗剂（ARB）是心力衰竭（心衰）药物治疗的基石。A-HeFT试验表明非洲裔美国人硝酸异山梨酯联合肼苯哒嗪组的生存率要高于安慰剂组。为了建立最优的心衰治疗方案，您认为应该整合不同作用机制的各种治疗方法吗？

International Circulation: One day perhaps we will see a poly-pill with ACE inhibitor， ARB， and renin inhibitor?

Jay Cohn: I believe there will be trial trying to put all three together and it will be interesting to determine if that produces an additive effect. The limiting factor in all these studies is that wwe are using doses of the other drugs that are not fully inhibitory. If you have a very large dose of， say， an ARB， you would make it unnecessary to give any of the other drugs. We do not use ARBs， ACE inhibitors， or the renin inhibitors in those high doses so we find incremental benefit when each is added to the other. The high dose concern for any one of these agents is that the blood pres

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