Where Are We With Treatment and Prevention of Heart Failure in Patients Post–Myocardial Infarction?,JACC: Heart Failure

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Where Are We With Treatment and Prevention of Heart Failure in Patients Post–Myocardial Infarction?
JACC: Heart Failure ( IF 10.3 ) Pub Date : 2024-06-12 , DOI: 10.1016/j.jchf.2024.04.025
Jaclyn Carberry ₁ , Guillaume Marquis-Gravel ₂ , Eileen O'Meara ₂ , Kieran F Docherty ₃

Affiliation

As a result of the widespread use of reperfusion therapies and secondary prevention over the last 30 years, there has been a dramatic reduction in the risk of mortality and development of heart failure (HF) following acute myocardial infarction (MI). Despite this, the development of chronic HF remains a common occurrence in the days, months, and years following MI. Neurohormonal inhibition remains the mainstay of pharmacologic prevention of HF following MI, with recent trials showing an additive benefit of a neprilysin inhibitor or a sodium glucose co-transporter 2 inhibitor in reducing the risk of development of HF but no significant effect on mortality. Novel imaging tools may help refine risk stratification in high-risk patients and allow greater targeting of preventative therapies in patients most likely to benefit. Research is ongoing into novel therapies aiming to minimize the degree of myocardial damage and prevention of progressive adverse remodeling following MI.

中文翻译：

心肌梗死后患者心力衰竭的治疗和预防进展如何？

过去 30 年，由于再灌注疗法和二级预防的广泛使用，急性心肌梗死 (MI) 后的死亡率和心力衰竭 (HF) 风险显着降低。尽管如此，慢性心力衰竭的发生在心肌梗死后的数天、数月和数年中仍然很常见。神经激素抑制仍然是 MI 后心力衰竭药物预防的主要手段，最近的试验表明，脑啡肽酶抑制剂或钠葡萄糖协同转运蛋白 2 抑制剂在降低心力衰竭发生风险方面具有附加益处，但对死亡率没有显着影响。新颖的成像工具可能有助于细化高危患者的风险分层，并允许更有针对性地对最有可能受益的患者进行预防性治疗。目前正在研究新疗法，旨在最大限度地减少心肌损伤程度并预防心肌梗死后进行性不良重塑。

更新日期：2024-06-12

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