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沙库巴曲缬沙坦联合达格列净治疗急性心肌梗死后心力衰竭合并糖尿病患者的疗效

Efficacy of sacubitril/valsartan combined with dapagliflozin in treating patients with heart failure and diabetes after an acute myocardial infarction.

作者信息

Zhang Lifang, Tang Xiuying, Li Runjun, Niu Jinxia, Gong Jie

机构信息

Lifang Zhang Comprehensive Internal Medicine The First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei, China.

Xiuying Tang Department of Cardiology The First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei, China.

出版信息

Pak J Med Sci. 2024 Dec;40(11):2464-2469. doi: 10.12669/pjms.40.11.8972.

Abstract

OBJECTIVE

To investigate the efficacy of sacubitril/valsartan combined with dapagliflozin in diabetic patients suffering from heart failure following an acute myocardial infarction.

METHODS

This retrospective study included 80 diabetic patients who had heart failure after an acute myocardial infarction (AMI) and were hospitalised at First Hospital of Qinhuangdao between January 2021 and January 2023. They were randomly divided into the control and observation groups (each group n = 40). In addition to fundamental anti-heart failure treatment, the control group was administered with sacubitril/valsartan, whereas the observation group received sacubitril/valsartan combined with dapagliflozin. The treatment lasted for six months, and the patient's glucose-associated targets and prognosis before and after treatment were compared in both groups.

RESULTS

Six months after the treatment, the fasting blood glucose, 2-h postprandial blood glucose and HbA1c levels of patients from both groups significantly decreased. The decrease was more prominent in the observation group than in the control group, with significant differences ( 0.05). Additionally, the LVEF, CO, CI and NT-proBNP levels considerably decreased in both groups after treatment, with the observation group exhibiting a more notable decrease that was significantly different ( 0.05). An inter-group comparison showed that the differences were not significant ( 0.05).

CONCLUSIONS

In diabetic patients suffering from heart failure after an AMI, treatment with sacubitril/valsartan combined with dapagliflozin may effectively control blood glucose levels and improve cardiac functions without increasing adverse reactions, indicating high clinical safety.

摘要

目的

探讨沙库巴曲缬沙坦联合达格列净对急性心肌梗死后合并心力衰竭的糖尿病患者的疗效。

方法

本回顾性研究纳入了80例于2021年1月至2023年1月在秦皇岛市第一医院住院的急性心肌梗死(AMI)后合并心力衰竭的糖尿病患者。他们被随机分为对照组和观察组(每组n = 40)。除基础抗心力衰竭治疗外,对照组给予沙库巴曲缬沙坦,而观察组接受沙库巴曲缬沙坦联合达格列净治疗。治疗持续6个月,比较两组患者治疗前后的血糖相关指标和预后。

结果

治疗6个月后,两组患者的空腹血糖、餐后2小时血糖和糖化血红蛋白水平均显著降低。观察组的降低幅度比对照组更显著,差异有统计学意义(P < 0.05)。此外,两组治疗后左心室射血分数(LVEF)、心输出量(CO)、心脏指数(CI)和N末端脑钠肽前体(NT-proBNP)水平均显著降低,观察组降低更明显,差异有统计学意义(P < 0.05)。组间比较差异无统计学意义(P > 0.05)。

结论

对于急性心肌梗死后合并心力衰竭的糖尿病患者,沙库巴曲缬沙坦联合达格列净治疗可有效控制血糖水平并改善心功能,且不增加不良反应,临床安全性高。

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