SGLT2抑制剂对糖尿病急性心肌梗死患者左心室重构的影响

IF 2.5 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Pharmacology and Therapeutics Pub Date : 2024-01-01 DOI:10.1177/10742484241301191

Jun Wan, Feng Xu, Heping Zuo, Xin Jiang, Yulin Wang, Yang Jiang, Cai Chen, Chunlin Yin, Jinglin Cheng, He Li

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引用次数: 0

摘要

目的：探讨钠-葡萄糖共转运蛋白2抑制剂（SGLT2-I）对伴有急性心肌梗死（AMI）的2型糖尿病（T2DM）患者心脏重构及预后的影响。方法：在这项单中心回顾性主动比较研究中，纳入了2021年至2023年间连续接受经皮冠状动脉介入治疗（PCI）的糖尿病AMI患者。根据出院药物将患者分为SGLT2-I使用者和非SGLT2-I使用者。主要终点是左室重构指数（LVRI），定义为6个月后左室舒张末期容积的相对变化。次要结局包括主要不良心血管事件（MACE），包括全因死亡率、心力衰竭住院、非致死性心肌梗死和非致死性中风。结果：该研究纳入423例T2DM AMI患者（伴有或不伴有st段抬高），其中239例SGLT2-I使用者和184例非SGLT2-I使用者。6个月时，SGLT2-I组LVRI明显低于非SGLT2-I组（3.49±19.71 vs 7.06±15.15,P = 0.042）。非sglt2 - i使用者的阳性LVR （LVRI > 0%）患病率（64.67% vs 50.63%, P = 0.004）和病理性LVR （LVRI > 20%）患病率（19.57% vs 12.13%, P = 0.036）较高。多因素logistic回归显示，SGLT2-I与LVR风险降低相关(OR 0.6；95%可信区间0.38 - -0.97;p = .035)。在平均25±8个月的随访期间，Kaplan-Meier分析显示，非sglt2 - i使用者的无mace生存率较低（P = 0.005）。结论：SGLT2-I可以预防LVR，降低T2DM AMI患者不良心血管结局的风险。

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Impact of SGLT2 Inhibitors on Left Ventricular Remodeling in Diabetic Patients with Acute Myocardial Infarction.

Objective: To assess the effect of sodium-glucose cotransporter 2 inhibitors (SGLT2-I) on cardiac remodeling and prognosis in type 2 diabetes mellitus (T2DM) patients presenting with acute myocardial infarction (AMI).

Methods: In this single-center retrospective active-comparator study, consecutive diabetic AMI patients undergoing percutaneous coronary intervention (PCI) between 2021 and 2023 were enrolled. Patients were divided into SGLT2-I users and non-SGLT2-I users based on discharge medications. The primary endpoint was the left ventricular remodeling index (LVRI), defined as the relative change in LV end-diastolic volume after six months. The secondary outcomes included major adverse cardiovascular events (MACE), comprising all-cause mortality, hospitalization for heart failure, nonfatal MI, and nonfatal stroke.

Results: The study comprised 423 T2DM AMI patients(with or without ST-segment elevation), with 239 SGLT2-I users and 184 non-SGLT2-I users. At six months, LVRI was significantly lower in the SGLT2-I users compared to the non-SGLT2-I users (3.49 ± 19.71 vs 7.06 ± 15.15, P = .042). The non-SGLT2-I users exhibited a higher prevalence of positive LVR (LVRI > 0%) (64.67% vs 50.63%, P = .004) and pathological LVR (LVRI > 20%) (19.57% vs 12.13%, P = .036). Multivariate logistic regression indicated that SGLT2-I was associated with a reduced risk of LVR (OR 0.6; 95%CI 0.38-0.97; P = .035). During a mean follow-up of 25 ± 8 months, Kaplan-Meier analysis demonstrated a lower rate of MACE-free survival in the non-SGLT2-I users (P = .005).

Conclusions: SGLT2-I protects against LVR and lowers the risk of adverse cardiovascular outcomes in T2DM AMI patients.

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来源期刊

Journal of Cardiovascular Pharmacology and Therapeutics 医学-心血管系统

CiteScore

6.00

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Pharmacology and Therapeutics (JCPT) is a peer-reviewed journal that publishes original basic human studies, animal studies, and bench research with potential clinical application to cardiovascular pharmacology and therapeutics. Experimental studies focus on translational research. This journal is a member of the Committee on Publication Ethics (COPE).