Xue LiMing, Yuan Xian, Zhang Shuguang, Zhao Xia
Department of Cardiology, Lianshui County People's Hospital, Huaian, Jiangsu 223400, China.
Department of Cardiology, The Second People's Hospital of Huai'an, Huai'an Hospital Affiliated to Xuzhou Medical University, Huaian, Jiangsu 223002, China.
Evid Based Complement Alternat Med. 2021 Oct 15;2021:9388562. doi: 10.1155/2021/9388562. eCollection 2021.
To explore the effect of dapagliflozin on cardiac function, inflammation, and cardiovascular outcome in patients with ST-segment elevation myocardial infarction (STEMI) combined with type 2 diabetes (T2DM) after percutaneous coronary intervention (PCI).
70 patients with STEMI and T2DM were divided into the control group ( = 35) and the observation group ( = 35). Before surgery, patients in both groups were given conventional treatments such as coronary expansion, antiplatelet, anticoagulation, and thrombolysis, and PCI was performed. After the operation, both groups were given conventional antiplatelet, anticoagulation, lipid-lowering, and hypoglycemic treatments. On this basis, the observation group was treated with dapagliflozin tablets for 24 weeks. We observe and compare the left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF), myocardial enzyme spectrum, inflammatory reaction, and occurrence of adverse cardiovascular events (MACE) of the two groups of patients before and after treatment.
After treatment, the LVEDD and LVESD of the two groups were lower than those before treatment, and the observation group was lower than the control group ( < 0.05). The LVEF of both groups was higher than that before treatment, and the observation group was higher than the control group ( < 0.05). After treatment, the levels of two groups' patients' creatine kinase (CK), creatine kinase isoenzyme (CK-MB), and troponin I (cTnI) were all lower than those before treatment, and the observation group patients were all lower than the control group ( < 0.05). After treatment, the levels of serum myeloperoxidase (MPO), C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor- (TNF-) in the two groups were all lower than those before treatment, and the observation group patients were all lower than the control group ( < 0.05). After treatment, there was no statistical difference between the two groups of patients in cardiogenic death, recurrent myocardial infarction, and other adverse cardiovascular events ( > 0.05). But, the incidence of severe arrhythmia and heart failure in the observation group were both lower than those in the control group ( < 0.05). Kaplan-Meier survival curve analysis showed that the median survival time without MACE in the observation group was higher than that in the control group ( < 0.05).
Dapagliflozin treatment for patients with STEMI combined with T2DM after PCI can improve cardiac function to certain extent, reduce inflammation, and will reduce the incidence of adverse cardiovascular outcomes.
探讨达格列净对ST段抬高型心肌梗死（STEMI）合并2型糖尿病（T2DM）患者经皮冠状动脉介入治疗（PCI）后心功能、炎症及心血管结局的影响。
将70例STEMI合并T2DM患者分为对照组（n = 35）和观察组（n = 35）。术前，两组患者均给予冠状动脉扩张、抗血小板、抗凝和溶栓等常规治疗，并进行PCI。术后，两组均给予常规抗血小板、抗凝、降脂和降糖治疗。在此基础上，观察组给予达格列净片治疗24周。观察并比较两组患者治疗前后的左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）和左心室射血分数（LVEF）、心肌酶谱、炎症反应及不良心血管事件（MACE）的发生情况。
治疗后，两组的LVEDD和LVESD均低于治疗前，且观察组低于对照组（P < 0.05）。两组的LVEF均高于治疗前，且观察组高于对照组（P < 0.05）。治疗后，两组患者的肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）和肌钙蛋白I（cTnI）水平均低于治疗前，且观察组患者均低于对照组（P < 0.05）。治疗后，两组患者血清髓过氧化物酶（MPO）、C反应蛋白（CRP）、白细胞介素6（IL-6）和肿瘤坏死因子-α（TNF-α）水平均低于治疗前，且观察组患者均低于对照组（P < 0.05）。治疗后，两组患者在心源性死亡、再发心肌梗死等不良心血管事件方面无统计学差异（P > 0.05）。但是，观察组严重心律失常和心力衰竭的发生率均低于对照组（P < 0.05）。Kaplan-Meier生存曲线分析显示，观察组无MACE的中位生存时间高于对照组（P < 0.05）。
达格列净治疗PCI术后STEMI合并T2DM患者可在一定程度上改善心功能，减轻炎症，并降低不良心血管结局的发生率。
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