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钠-葡萄糖协同转运蛋白 2(SGLT-2)抑制剂在射血分数降低的心力衰竭伴 2 型糖尿病、糖尿病前期和血糖正常的患者中是否具有相似的心血管获益?

Do SGLT-2 inhibitors exhibit similar cardiovascular benefit in patients having reduced ejection fraction heart failure with type 2 diabetes, prediabetes and normoglycemia?

机构信息

Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, Kolkata, India.

Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, Kolkata, India.

出版信息

Diabetes Metab Syndr. 2021 Nov-Dec;15(6):102282. doi: 10.1016/j.dsx.2021.102282. Epub 2021 Sep 16.

DOI:10.1016/j.dsx.2021.102282
PMID:34562869
Abstract

BACKGROUND AND AIMS

We aimed to know whether SGLT-2 inhibitors (SGLT-2I) exhibit similar cardiovascular (CV) benefit in patients having reduced ejection fraction heart failure (HFrEF) with varying degree of glycemia.

METHOD

We meta-analyzed the trial-level hazard ratio and 95% confidence interval of randomized trials that reported the CV outcomes stratified in to three subgroups of normoglycemia, prediabetes and diabetes.

RESULTS

This meta-analysis found a significant and similar CV risk reduction in patients with HFrEF without any significant interaction between three subgroups (P = 0.98).

CONCLUSIONS

SGLT-2I exhibit similar CV risk reduction in HFrEF, regardless of baseline glycemic status. However, this finding is limited to pooled data from only 2 studies in people without T2DM.

摘要

背景和目的

我们旨在了解 SGLT-2 抑制剂(SGLT-2I)在射血分数降低的心力衰竭(HFrEF)伴有不同程度血糖的患者中是否具有相似的心血管(CV)获益。

方法

我们对报告 CV 结局的随机试验进行了试验水平的风险比和 95%置信区间的荟萃分析,并将其分层为正常血糖、糖尿病前期和糖尿病三个亚组。

结果

这项荟萃分析发现,在 HFrEF 患者中,SGLT-2I 显著且相似地降低了 CV 风险,且三个亚组之间没有显著的相互作用(P=0.98)。

结论

SGLT-2I 在 HFrEF 中具有相似的 CV 风险降低作用,无论基线血糖状态如何。然而,这一发现仅限于来自没有 T2DM 的 2 项研究的汇总数据。

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