钠-葡萄糖共转运蛋白2抑制剂在2型糖尿病和心肌梗死患者经皮冠状动脉介入治疗中的应用：一项系统综述和荟萃分析

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2024-12-31 DOI:10.1016/j.ajpc.2024.100927

Huzaifa Ul Haq Ansari , Muhammad Ammar Samad , Eman Mahboob , Eeshal Zulfiqar , Shurjeel Uddin Qazi , Areeba Ahsan , Mushood Ahmed , Faizan Ahmed , Raheel Ahmed , Shafaqat Ali , Mahboob Alam , Jamal S. Rana , Gregg C. Fonarow

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引用次数: 0

摘要

背景：钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）已显示出改善心力衰竭（HF）患者心血管（CV）结局的益处，并可能缓解心肌梗死（MI）的症状进展。然而，它们对2型糖尿病和心肌梗死患者经皮冠状动脉介入治疗（PCI）的有效性尚不清楚。方法：为了确定符合条件的研究，从成立到2024年5月，对PubMed、Cochrane Library、Scopus和Embase等电子数据库进行了全面检索。结果以风险比（RR）及其相应的95%置信区间（ci）表示。结果：我们的分析包括8项观察性研究，包括24229例患者。结果显示，SGLT2i合并PCI与全因死亡风险显著降低相关(RR=0.61；95% CI=0.54 ~ 0.68)， CV死亡(RR=0.46；95% CI=0.22 ~ 0.94)、主要不良心血管事件（RR=0.80; 95% CI: 0.66 ~ 0.96）、hf相关住院(RR=0.63；95% CI=0.44 ~ 0.90)，卒中(RR=0.77；95% CI: 0.62 ~ 0.96)和急性肾损伤(RR=0.46；95% CI: 0.25 ~ 0.84)，与未使用SGLT2i的PCI相比。然而，两组间血运重建的风险仍具有可比性。结论：我们的研究表明，与不使用SGLT2i的PCI相比，2型糖尿病和心肌梗死患者的SGLT2i与改善的CV结果相关。需要随机对照试验来证实SGLT2i联合PCI治疗心肌梗死和糖尿病患者的预后改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes and myocardial infarction undergoing percutaneous coronary intervention: A systematic review and meta-analysis

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Sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes and myocardial infarction undergoing percutaneous coronary intervention: A systematic review and meta-analysis

Background

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown benefits in improving cardiovascular (CV) outcomes in patients with heart failure (HF) and may mitigate symptom progression in myocardial infarction (MI). However, their effectiveness in patients with type 2 diabetes and MI undergoing percutaneous coronary intervention (PCI) is unclear.

Methods

To identify eligible studies, a comprehensive search of electronic databases, PubMed, Cochrane Library, Scopus and Embase, was conducted from inception until May 2024. Results were presented as risk ratios (RR) and their corresponding 95 % confidence intervals (CIs).

Results

Our analysis included 8 observational studies comprising 24,229 patients. The results indicated that SGLT2i with PCI was associated with a significantly reduced risk of all-cause death (RR=0.61; 95 % CI=0.54 to 0.68), CV death (RR=0.46; 95 % CI=0.22 to 0.94), major adverse cardiovascular events (RR=0.80;95 % CI: 0.66 to 0.96), HF-related hospitalizations (RR=0.63; 95 % CI=0.44 to 0.90), stroke (RR=0.77; 95 % CI: 0.62 to 0.96) and acute kidney injury (RR=0.46; 95 % CI: 0.25 to 0.84) compared to PCI without SGLT2i use. However, the risk of revascularization remained comparable between the groups.

Conclusion

Our study demonstrates that SGLT2i with PCI in patients with type 2 diabetes and MI are associated with improved CV outcomes compared to PCI without SGLT2i use. Randomized controlled trials are required to confirm the improvement in outcomes with SGLT2i therapy combined with PCI in patients with MI and diabetes.

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来源期刊

American journal of preventive cardiology Cardiology and Cardiovascular Medicine

CiteScore

6.60

自引率

0.00%

发文量

审稿时长

76 days