Huynh Tuong Le Trong, Pham Phong Thanh, Tran Hien Dieu, Tran Nhan Dinh, Tran Duong Van, Tran Bao Lam Thai, Tran Khoa Dang Dang, Ngo Toan Hoang, Tran Son Kim
Department of Cardiology and Rheumatology, Can Tho Central General Hospital, Can Tho, Ninh Kieu, Vietnam.
Department of Internal Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Ninh Kieu, Vietnam.
PeerJ. 2024 Nov 29;12:e18595. doi: 10.7717/peerj.18595. eCollection 2024.
Sodium-Glucose Transport Protein 2 (SGLT2) inhibitors, and Angiotensin II Receptor Antagonists (ARBs) also have the effect of reducing serum uric acid but few studies worldwide assessed.
Evaluate the effectiveness of serum uric acid lowering treatment of SGLT2 inhibitors, and ARB in heart failure (HF) patients.
We conducted a cross-sectional analysis study with 8 weeks of follow-up on 733 heart failure (HF) patients treated at Can Tho Central General Hospital from January 2023 to March 2024. Patients enrolled in the study were examined and received losartan (Group A) or dapagliflozin (Group B) monotherapy or losartan and dapagliflozin combined therapy (Group C). The uric acid concentration group was defined into three subgroups with tertile 1 from smallest to quartile (Q) 1, tertile 2 from Q2 to Q3, and tertile 3 from Q3 to the largest value.
After 8 weeks of treatment, the uric acid reduction effect between groups A, B, and C showed that the combination group had the optimal reducing effect compared to losartan and dapagliflozin monotherapy with the mean difference being -229.62 ± 76.65 µmol/L, -217.00 ± 146.17 µmol/L, and -284.43 ± 136.32 µmol/L, respectively. In total, combination therapy showed the best reduction outcome in the population of male, female, patients with type 2 diabetes mellitus (T2DM), and dyslipidemia with the mean difference ranging from -226.21 ± 74.65 µmol/L to -231.85 ± 76.28 µmol/L and -209.62 ± 184.94 µmol/L to -225.75 ± 78.53 µmol/L and -273.02 ± 204.54 µmol/L to -308.93 ± 72.97 µmol/L in group A, B, and C, respectively.
The optimal therapy for reducing uric acid levels in HF patients was the combination of losartan and dapagliflozin, and the effectiveness did not change through sex, T2DM, and dyslipidemia patients.
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂和血管紧张素II受体拮抗剂（ARB）也具有降低血清尿酸的作用，但全球范围内此类研究较少。
评估SGLT2抑制剂和ARB降低心力衰竭（HF）患者血清尿酸的疗效。
我们对2023年1月至2024年3月在芹苴中央综合医院接受治疗的733例心力衰竭（HF）患者进行了为期8周随访的横断面分析研究。纳入研究的患者接受了氯沙坦（A组）或达格列净（B组）单药治疗，或氯沙坦与达格列净联合治疗（C组）。尿酸浓度组被分为三个亚组，三分位数1为最小值至四分位数（Q）1，三分位数2为Q2至Q3，三分位数3为Q3至最大值。
治疗8周后，A、B、C三组之间的尿酸降低效果显示，联合治疗组的降低效果优于氯沙坦和达格列净单药治疗，平均差异分别为-229.62±76.65µmol/L、-217.00±146.17µmol/L和-284.43±136.32µmol/L。总体而言，联合治疗在男性、女性、2型糖尿病（T2DM）患者和血脂异常患者中显示出最佳的降低效果，A、B、C组的平均差异分别为-226.21±74.65µmol/L至-231.85±76.28µmol/L、-209.62±184.94µmol/L至-225.75±78.53µmol/L以及-273.02±204.54µmol/L至-308.93±72.97µmol/L。
降低HF患者尿酸水平的最佳治疗方法是氯沙坦和达格列净联合使用，且疗效在不同性别、T2DM患者和血脂异常患者中无差异。
