Department of Cardiology, Shibei Hospital of Jingan District, Shanghai, China -
Department of Cardiology, Shibei Hospital of Jingan District, Shanghai, China.
Minerva Cardiol Angiol. 2024 Jun;72(3):292-298. doi: 10.23736/S2724-5683.23.06478-5. Epub 2024 Feb 23.
Dapagliflozin is a selective SGLT2 inhibitor, which has been widely used in the treatment of patients with type 2 diabetes mellitus (T2DM). By blocking the reabsorption of glucose in renal tubules, daglitazine can promote urinary glucose excretion, reduce blood glucose and blood pressure, and also shows a protective effect on the heart in clinical studies. Accordingly, this study was designed to explore the effects of dapagliflozin on cardiac function and short-term prognosis of patients with acute myocardial infarction (AMI) complicated with T2DM.
The clinical data of 100 patients with both AMI and T2DM treated at Shibei Hospital of Jingan District from January 2021 to January 2023 were analyzed retrospectively. Totally 47 patients treated with hypoglycemic agents other than SGLT-2i inhibitors on the basis of routine treatment were assigned to the control group, and 53 patients treated with dapagliflozin based on treatment of the control group were assigned to the study group. Relevant blood glucose-related indices and cardiac function-associated indices of the two groups before and after treatment were analyzed and compared: The adverse reactions of the two groups were statistically analyzed, including hypotension, hypoglycemia, diarrhea and abdominal pain, anorexia, and nausea and vomiting. The patients were followed-up for six months, on which the major cardiovascular adverse events (MACE) and incidence of readmission for heart failure in the two groups were analyzed and compared.
Treatment, the FBG, 2h PG and HbA1c levels in both groups dropped significantly (P<0.05), with significantly lower levels in the study group (P<0.05). After treatment, both groups showed significantly dropped NT-pro BNP, LVEDD and LVESD levels (P<0.05) and a significantly increased LVEF level (P<0.05), with more significant drops/increase in the study group (P<0.05). No significant difference was found between the two groups in the total incidence of adverse reactions (P=0.586). During the follow-up period, there was no significant difference in the incidence of MACE between the two groups (P>0.05), and the study group showed a significantly lower incidence of readmission for heart failure than the control group (P<0.05).
Dapagliflozin can substantially improve the blood glucose and cardiac function of patients with both AMI and T2DM. It can lower the rate of readmission for heart failure, and provide various cardiovascular benefits besides hypoglycemic effect.
达格列净是一种选择性 SGLT2 抑制剂,已广泛用于治疗 2 型糖尿病(T2DM)患者。通过阻断肾小管中葡萄糖的重吸收,达格列净可以促进尿糖排泄,降低血糖和血压,并且在临床研究中对心脏也表现出保护作用。因此,本研究旨在探讨达格列净对急性心肌梗死(AMI)合并 T2DM 患者心功能和短期预后的影响。
回顾性分析 2021 年 1 月至 2023 年 1 月静安区市北医院收治的 100 例 AMI 合并 T2DM 患者的临床资料。根据常规治疗基础上加用 SGLT-2i 抑制剂以外的降糖药物治疗的 47 例患者设为对照组,在对照组治疗基础上加用达格列净治疗的 53 例患者设为研究组。分析比较两组治疗前后相关血糖相关指标和心功能相关指标:统计两组不良反应,包括低血压、低血糖、腹泻和腹痛、食欲不振和恶心呕吐。两组患者均随访 6 个月,分析比较两组主要心血管不良事件(MACE)和心力衰竭再入院发生率。
治疗后,两组 FBG、2hPG 和 HbA1c 水平均明显下降(P<0.05),且研究组明显更低(P<0.05)。治疗后,两组 NT-proBNP、LVEDD 和 LVESD 水平均明显下降(P<0.05),LVEF 水平明显升高(P<0.05),且研究组下降/升高更明显(P<0.05)。两组不良反应总发生率比较差异无统计学意义(P=0.586)。随访期间,两组 MACE 发生率比较差异无统计学意义(P>0.05),研究组心力衰竭再入院率明显低于对照组(P<0.05)。
达格列净可明显改善 AMI 合并 T2DM 患者的血糖和心功能,降低心力衰竭再入院率,除降糖作用外还可提供多种心血管获益。