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[ACC2012]NCDR获益与局限——Dr John A. Dodson专访
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作者:JohnA.Dodson 编辑:国际循环网 时间:2012/3/26 17:51:36    加入收藏

 标签:专家访谈(专题)  关键字:John A. Dodson   ICDs  NCDR 

  <International Circulation>:  It seems to be casting a very wide net for what is optimal medical therapy. Could it be that patients are on other medications that could be considered optimal medical therapy?

  《国际循环》:这似乎对什么是最佳药物治疗划定了一个范围很广的框架。有无其他药物也可被视为最佳药物治疗呢?

  Dr Dodson:  You could certainly include other drugs but as you get more specific in adding drugs like spironolactone or diuretics, there is evidence but it is not quite as definitive and as set-in-stone as the beta-blocker and ACE-inhibitor. That is something I think the majority of cardiologists would agree with, that patients should be taking unless there is some reason why they should not.

  Dr Dodson: 当然可以包括其他药物,但是当你考虑添加其他药物如螺内酯或其他利尿剂时,这些药物也有获益的证据,但其证据远不如β受体阻滞剂和ACEI那样明确和无可辩驳。我想绝大多数心脏病医生都同意,除非有充足理由不使用,否则患者均应服用β受体阻滞剂和ACEI。

  <International Circulation>:  You showed an improvement in reduction of complications and the ability to receive optimal medical therapy and in receiving CRT devices. Is there a correlation between all of those things or is that something that has not been established yet? Does receiving optimal medical therapy mean that you have fewer complications?

  《国际循环》:您的研究结果显示在减少并发症、接受最佳药物治疗和接受CRT装置植入方面获得了改善。所有这些方面之间是否存在关联?或者还有哪些问题没有得到解决?接受最佳药物治疗是否意味减少并发症?

  Dr Dodson:  Optimal medical therapy is coded at the time of discharge so I think that is less likely to be correlated. The complications are related to the procedure itself. However, if a patient is on optimal medical therapy, the question may be are there fewer things that happen to them in the future such as hospitalization mortality. Complications are very discrete. Complications are related to the placement of the ICD and I cannot see how that can be related to optimal medical therapy.

  Dr Dodson: 出院时对最佳药物治疗进行编码,因此我认为这与其他方面不存在相关性。并发症与手术本身有关。然而,如果患者接受了最佳药物治疗,我们关心的问题可能是未来院内死亡等事件的发生是否会减少。并发症非常孤立,与ICD的安置有关,我看不出这与最佳药物治疗有何关联。
 



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