Lv Yuan, Luo Wei-Jun
Department of Cardiology, Lishui People's Hospital, Lishui 323000, Zhejiang Province, China.
World J Clin Cases. 2024 Aug 6;12(22):5008-5015. doi: 10.12998/wjcc.v12.i22.5008.
Coronary heart disease and type 2 diabetes mellitus (T2DM) frequently coexist, creating a complex and challenging clinical scenario, particularly when complicated with acute myocardial infarction (AMI).
To examine the effects of dapagliflozin combined with sakubactrovalsartan sodium tablets on myocardial microperfusion.
In total, 98 patients were categorized into control ( = 47) and observation ( = 51) groups. The control group received noxital, while the observation group was treated with dapagliflozin combined with noxital for 6 months. Changes in myocardial microperfusion, blood glucose level, cardiac function, N-terminal prohormone of brain natriuretic peptide (NT-proBNP) level, growth differentiation factor-15 (GDF-15) level, and other related factors were compared between the two groups. Additionally, the incidence of major adverse cardiovascular events (MACE) and adverse reactions were calculated.
After treatment, in the observation and control groups, the corrected thrombolysis in myocardial infarction frame counts were 37.12 ± 5.02 and 48.23 ± 4.66, respectively. The NT-proBNP levels were 1502.65 ± 255.87 and 2015.23 ± 286.31 pg/mL, the N-terminal pro-atrial natriuretic peptide (NT-proANP) levels were 1415.69 ± 213.05 and 1875.52 ± 241.02 ng/mL, the GDF-15 levels were 0.87 ± 0.43 and 1.21 ± 0.56 g/L, and the high-sensitivity C-reactive protein (hs-CRP) levels were 6.54 ± 1.56 and 8.77 ± 1.94 mg/L, respectively, with statistically significant differences ( < 0.05). The cumulative incidence of MACEs in the observation group was significantly lower than that in the control group ( < 0.05). The incidence of adverse reactions was 13.73% (7/51) in the observation group and 10.64% (5/47) in the control group, with no statistically significant difference ( > 0.05).
Dapagliflozin combined with nocinto can improve myocardial microperfusion and left ventricular remodeling and reduce MACE incidence in patients with post-AMI heart failure and T2DM. The underlying mechanism may be related to the reduction in the expression levels of NT-proANP, GDF-15, and hs-CRP.
冠心病与2型糖尿病（T2DM）常并存，形成复杂且具有挑战性的临床情况，尤其是在合并急性心肌梗死（AMI）时。
探讨达格列净联合沙库巴曲缬沙坦钠片对心肌微灌注的影响。
总共98例患者被分为对照组（n = 47）和观察组（n = 51）。对照组接受诺欣妥治疗，而观察组接受达格列净联合诺欣妥治疗6个月。比较两组之间心肌微灌注、血糖水平、心功能、脑钠肽前体N端片段（NT-proBNP）水平、生长分化因子-15（GDF-15）水平及其他相关因素的变化。此外，计算主要不良心血管事件（MACE）的发生率和不良反应。
治疗后，观察组和对照组的心肌梗死溶栓校正帧数分别为37.12±5.02和48.23±4.66。NT-proBNP水平分别为1502.65±255.87和2015.23±286.31 pg/mL，N端前心房钠尿肽（NT-proANP）水平分别为1415.69±213.05和1875.52±241.02 ng/mL，GDF-15水平分别为0.87±0.43和1.21±0.56 μg/L，高敏C反应蛋白（hs-CRP）水平分别为6.54±1.56和8.77±1.94 mg/L，差异均有统计学意义（P<0.05）。观察组MACE的累积发生率显著低于对照组（P<0.05）。观察组不良反应发生率为13.73%（7/51），对照组为10.64%（5/47），差异无统计学意义（P>0.05）。
达格列净联合诺欣妥可改善AMI后心力衰竭合并T2DM患者的心肌微灌注和左心室重构，并降低MACE发生率。其潜在机制可能与NT-proANP、GDF-15和hs-CRP表达水平降低有关。
