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GLP1-受体激动剂或 SGLT2 抑制剂治疗在 2 型糖尿病患者一级心血管预防中的作用:一项 24 个月随访研究。

Decrease of coronary heart disease risk with GLP1-receptor agonists or SGLT2 inhibitors therapy in patients with type 2 diabetes in primary cardiovascular prevention: A 24 months follow-up study.

机构信息

Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy.

Santa Maria Goretti Hospital, Polo Pontino Sapienza University, Via Guido Reni, Latina, Italy.

出版信息

Diabetes Res Clin Pract. 2021 Mar;173:108681. doi: 10.1016/j.diabres.2021.108681. Epub 2021 Jan 28.

Abstract

AIMS

The aim of this real-world study is to evaluate the effect of glucagon-like peptide1 receptor-agonist (GLP1 RA) and sodium-glucose co-transporter2 inhibitor (SGLT2i) on coronary heart disease (CHD) risk, in patients with type 2 diabetes (T2D) in primary cardiovascular prevention.

METHODS

Data from 312 patients with T2D, without CHD history, starting treatment with GLP1 RA (n = 174) or SGLT2i (n = 138), were retrospectively collected. UKPDS-RE score was used to estimate 10-years risk for CHD before and 6, 12 and 24 months after prescription.

RESULTS

The 10-year CHD risk significantly decreased over 24 months in both GLP1 RA and SGLT2i groups (p = 0.037 and p < 0.001, respectively), with 3% and 7% CHD risk reduction already obtained after the first 6 months of GLP1 RA and SGLT2i therapy respectively (p < 0.001 in both groups. Analyses by categories of baseline CHD risk showed significant reductions of CHD risk in the severe risk categories of both groups (p < 0.001). CHD risk reduction obtained with SGLT2i was higher than with GLP1 RA at 6 and 12 months but not at 24 months.

CONCLUSION

This real-world study shows that both GLP1 RA and SGLT2i reduce the 10-year risk for cardiovascular disease in patients with T2D in primary cardiovascular prevention.

摘要

目的

本真实世界研究旨在评估胰高血糖素样肽 1 受体激动剂(GLP1RA)和钠-葡萄糖共转运蛋白 2 抑制剂(SGLT2i)在 2 型糖尿病(T2D)患者一级心血管预防中对冠心病(CHD)风险的影响。

方法

回顾性收集了 312 例无 CHD 病史、开始接受 GLP1RA(n=174)或 SGLT2i(n=138)治疗的 T2D 患者的数据。使用 UKPDS-RE 评分评估处方前和 6、12 和 24 个月后的 10 年 CHD 风险。

结果

GLP1RA 和 SGLT2i 组在 24 个月内 10 年 CHD 风险显著降低(p=0.037 和 p<0.001),GLP1RA 和 SGLT2i 治疗的前 6 个月分别降低 3%和 7%的 CHD 风险(两组均 p<0.001)。根据基线 CHD 风险分类的分析显示,两组严重风险类别的 CHD 风险均显著降低(两组均 p<0.001)。SGLT2i 在 6 和 12 个月时降低 CHD 风险的效果高于 GLP1RA,但在 24 个月时则不然。

结论

本真实世界研究表明,GLP1RA 和 SGLT2i 均可降低 T2D 患者一级心血管预防中的 10 年心血管疾病风险。

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