胰高血糖素样肽-1 受体激动剂的使用及其与心力衰竭和 2 型糖尿病预后的关系。数据来自瑞典心力衰竭和瑞典国家糖尿病登记处。

IF 5.3 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Markus Wallner, Mattia Emanuele Biber, Davide Stolfo, Gianfranco Sinagra, Lina Benson, Ulf Dahlström, Soffia Gudbjörnsdottir, Francesco Cosentino, Peter G M Mol, Giuseppe M C Rosano, Javed Butler, Marco Metra, Lars H Lund, Giulia Ferrannini, Gianluigi Savarese
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引用次数: 0

摘要

目的:评估现实世界中心力衰竭(HF)和2型糖尿病(T2DM)患者使用胰高血糖素样肽-1受体激动剂(GLP-1 RA)的情况及其与治疗效果的关系:瑞典心力衰竭登记处与国家糖尿病登记处及其他国家登记处联网。通过多变量逻辑回归评估了GLP-1 RA使用的独立预测因素,并在1:1倾向得分匹配队列中通过Cox回归评估了与结果的关联。在2017-2021年入组的8188名患者中,9%接受了GLP-1 RA治疗。使用GLP-1 RA的独立预测因素是年龄结论:在HF和T2DM患者中,GLP-1 RA的使用与更严重的T2DM、EF降低和肥胖独立相关,与更高的HHF/CV死亡风险无关,但与更长的生存期和更少的主要CV不良事件有关。在肥胖患者中观察到与较低的 HHF/CV 死亡和 HHF 有关。我们的研究结果为 GLP-1 RA 在高血压和 T2DM 中的应用及其安全性提供了新的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Glucagon-like peptide-1 receptor agonists use and associations with outcomes in heart failure and type 2 diabetes: data from the Swedish Heart Failure and Swedish National Diabetes Registries.

Aims: To assess the use and associations with outcomes of glucagon-like peptide-1 receptor agonists (GLP-1 RA) in a real-world population with heart failure (HF) and type 2 diabetes mellitus (T2DM).

Methods and results: The Swedish HF Registry was linked with the National Diabetes Registry and other national registries. Independent predictors of GLP-1 RA use were assessed by multivariable logistic regressions and associations with outcomes were assessed by Cox regressions in a 1:1 propensity score-matched cohort. Of 8188 patients enrolled in 2017-21, 9% received a GLP-1 RA. Independent predictors of GLP-1 RA use were age <75 years, worse glycaemic control, impaired renal function, obesity, and reduced ejection fraction (EF). GLP-1 RA use was not significantly associated with a composite of HF hospitalization (HHF) or cardiovascular (CV) death regardless of EF, but was associated with a lower risk of major adverse CV events (CV death, non-fatal stroke/transient ischaemic attack, or myocardial infarction), and CV and all-cause death. In patients with body mass index ≥30 kg/m2, GLP-1 RA use was also associated with a lower risk of HHF/CV death and HHF alone.

Conclusions: In patients with HF and T2DM, GLP-1 RA use was independently associated with more severe T2DM, reduced EF, and obesity and was not associated with a higher risk of HHF/CV death but with longer survival and less major CV adverse events. An association with lower HHF/CV death and HHF was observed in obese patients. Our findings provide new insights into GLP-1 RA use and its safety in HF and T2DM.

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来源期刊
European Heart Journal - Cardiovascular Pharmacotherapy
European Heart Journal - Cardiovascular Pharmacotherapy Medicine-Cardiology and Cardiovascular Medicine
CiteScore
10.10
自引率
14.10%
发文量
65
期刊介绍: The European Heart Journal - Cardiovascular Pharmacotherapy (EHJ-CVP) is an international, peer-reviewed journal published in English, specifically dedicated to clinical cardiovascular pharmacology. EHJ-CVP publishes original articles focusing on clinical research involving both new and established drugs and methods, along with meta-analyses and topical reviews. The journal's primary aim is to enhance the pharmacological treatment of patients with cardiovascular disease by interpreting and integrating new scientific developments in this field. While the emphasis is on clinical topics, EHJ-CVP also considers basic research articles from fields such as physiology and molecular biology that contribute to the understanding of cardiovascular drug therapy. These may include articles related to new drug development and evaluation, the physiological and pharmacological basis of drug action, metabolism, drug interactions, and side effects.
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