研究 Ertugliflozin 对糖尿病和代谢综合征患者心血管预后的影响:临床试验系统回顾

Pharmaceuticals Pub Date : 2024-07-11 DOI:10.3390/ph17070929
S. Pescariu, Ahmed Elagez, Balaji Nallapati, F. Bratosin, Adina Bucur, A. Negru, L. Gaita, I. Citu, Z. Popa, Paula Irina Barata
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引用次数: 0

摘要

心血管疾病(CVD)是全球发病率和死亡率的重要原因,尤其是在2型糖尿病(T2DM)患者中。据推测,钠-葡萄糖共转运体-2(SGLT2)抑制剂 Ertugliflozin 可保护心血管;然而,有必要进行长期随访研究来支持这一假设。本系统综述旨在评估厄曲酶在糖尿病与非糖尿病队列中对心血管的影响,重点关注主要不良心血管事件(MACE)、心衰住院率和心血管死亡率。根据 PRISMA 指南,该综述涵盖了截至 2024 年 3 月在 PubMed、Scopus 和 Web of Science 上收录的研究。研究对象仅限于接受厄曲替尼治疗的 T2DM 患者,并报告了与心血管健康相关的结果。在初步确定的 767 篇文章中,有 6 篇符合纳入标准。我们提取了有关危险比 (HR) 和置信区间 (CI) 的数据,以比较厄曲酶与安慰剂或其他标准疗法的效果。这些研究的总样本量为 8246 人。与安慰剂相比,厄曲酶联用可显著减少因心衰而住院的人数(HR 0.70,95% CI 0.54-0.90,P < 0.05)。此外,当与二甲双胍联用时,厄曲替尼有可能降低MACE(HR 0.92,95% CI 0.79-1.07),尽管这一结果未达到统计学意义。重要的是,对于已有心力衰竭的患者,厄曲利嗪可显著减少心力衰竭的加重(HR 0.53,95% CI 0.33-0.84,P < 0.01)。总体而言,厄曲利嗪可明显减少 T2DM 患者因心衰而住院的次数,并可改善其他心血管预后。这些结果支持将ertugliflozin纳入心血管风险较高的T2DM患者的治疗方案,并证实了其在SGLT2抑制剂中的疗效。建议继续进行研究,以确定其在不同患者群体中的长期心血管益处,包括对心律失常的潜在影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Examining the Impact of Ertugliflozin on Cardiovascular Outcomes in Patients with Diabetes and Metabolic Syndrome: A Systematic Review of Clinical Trials
Cardiovascular diseases (CVDs) constitute a significant cause of morbidity and mortality globally, particularly among individuals with type 2 diabetes mellitus (T2DM). Ertugliflozin, a Sodium-Glucose Co-transporter-2 (SGLT2) inhibitor, is hypothesized to confer cardiovascular protection; however, long-term follow-up studies are necessary to support the hypothesis. This systematic review was conducted to evaluate the cardiovascular effects of ertugliflozin in diabetic versus non-diabetic cohorts, focusing on major adverse cardiovascular events (MACEs), hospitalizations for heart failure, and cardiovascular mortality. Adhering to PRISMA guidelines, the review encompassed studies indexed in PubMed, Scopus, and Web of Science up to March 2024. Eligibility was restricted to studies involving T2DM patients undergoing ertugliflozin treatment with reported outcomes relevant to cardiovascular health. Out of 767 initially identified articles, 6 met the inclusion criteria. Data concerning hazard ratios (HR) and confidence intervals (CI) were extracted to compare the effects of ertugliflozin with those of a placebo or other standard therapies. The collective sample size across these studies was 8246 participants. Ertugliflozin was associated with a significant reduction in hospitalizations for heart failure relative to a placebo (HR 0.70, 95% CI 0.54–0.90, p < 0.05). Furthermore, when combined with metformin, ertugliflozin potentially reduced MACEs (HR 0.92, 95% CI 0.79–1.07), although this finding did not reach statistical significance. Importantly, for patients with pre-existing heart failure, ertugliflozin significantly decreased the exacerbations of heart failure (HR 0.53, 95% CI 0.33–0.84, p < 0.01). Overall, ertugliflozin markedly reduces hospitalizations due to heart failure in T2DM patients and may improve additional cardiovascular outcomes. These results endorse the integration of ertugliflozin into therapeutic protocols for T2DM patients at elevated cardiovascular risk and substantiate its efficacy among SGLT2 inhibitors. Continued investigations are recommended to delineate its long-term cardiovascular benefits in diverse patient populations, including the potential impact on arrhythmias.
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