Effect of dapagliflozin on malignant ventricular arrhythmias in elderly after acute myocardial infarction: a propensity score-matched cohort study.

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2025-04-01 DOI:10.1007/s00228-025-03832-8

Li Deng, Jingyi Wang, Ye Deng, Jianya Huang, Qingqing Gu, Qianwen Chen, Lu Pan, Jun Wei, Qingjie Wang, Ling Sun

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引用次数: 0

Abstract

Objective: This study aims to evaluate the effect of dapagliflozin (DAPA) on malignant ventricular arrhythmias (MVA) after acute myocardial infarction (AMI).

Methods: A single-center, prospective and observational cohort study was conducted. We enrolled AMI patients from the ChangZhou Acute Myocardial Infarction Registry between January 2018 and November 2023. They were divided into two groups according to the use of dapagliflozin. The median follow-up time was 211 days. The primary endpoint of the study was the incidence of MVA during hospitalization, and the secondary endpoint was all-cause mortality rate during the follow-up period. Kaplan-Meier survival analysis and multifactorial logistic regression analysis were performed to assess the association between DAPA and the risk of MVA. Enrolled patients were matched on a 1:1 propensity score.

Results: Of the 2607 AMI patients enrolled, MVA were reported postoperatively in 123 (4.7%)patients. Cardiovascular death occurred in 93 (3.6%) patients. The average age of the enrolled patients was 65.03 ± 0.27 years. Of participants assigned to dapagliflozin, 8 out of 363 patients (2.2%) experienced MVA compared with 115 out of 2244 patients (5.1%) in the control group (odds ratio, OR = 0.392; 95% confidence interval, 95% CI: 0.171-0.900; P = 0.027). After 1:1 propensity score matching, DAPA remained able to reduce the risk of MVA in patients with AMI. (OR = 0.340; 95% CI: 0.121-0.960; P = 0.042). At a median follow-up of 211 days, all-cause mortality remained lower in the DAPA group than in the control group after matching (P = 0.033).

Conclusion: Dapagliflozin may attenuate the risk of MVA and all-cause mortality in elderly AMI patients, highlighting its potential as a therapeutic adjunct. However, these findings require validation in large-scale randomized trials.

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达格列净对老年人急性心肌梗死后恶性室性心律失常的影响：一项倾向评分匹配队列研究。

目的：探讨达格列净（DAPA）对急性心肌梗死（AMI）后恶性室性心律失常（MVA）的治疗作用。方法：采用单中心、前瞻性、观察性队列研究。我们招募了常州市急性心肌梗死登记处2018年1月至2023年11月期间的AMI患者。根据达格列净的使用情况分为两组。中位随访时间为211天。研究的主要终点是住院期间MVA的发生率，次要终点是随访期间的全因死亡率。采用Kaplan-Meier生存分析和多因素logistic回归分析评估DAPA与MVA风险的相关性。入组患者按1:1的倾向评分进行匹配。结果：2607例AMI患者中，123例（4.7%）患者术后出现MVA。93例（3.6%）患者发生心血管死亡。入组患者平均年龄为65.03±0.27岁。在分配给达格列净的参与者中，363名患者中有8名（2.2%）经历了MVA，而对照组的2244名患者中有115名（5.1%）经历了MVA(优势比，OR = 0.392；95%置信区间，95% CI: 0.171-0.900；p = 0.027)。在1:1倾向评分匹配后，DAPA仍然能够降低AMI患者MVA的风险。(or = 0.340；95% ci: 0.121-0.960；p = 0.042)。在中位随访211天时，匹配后DAPA组的全因死亡率仍低于对照组（P = 0.033）。结论：达格列净可以降低老年AMI患者MVA和全因死亡率的风险，突出了其作为治疗辅助药物的潜力。然而，这些发现需要大规模随机试验的验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.