Durak Beyza Algul, Durak Musa Ilker, Ata Naim, Ülgü Mahir, Birinci Şuayip
Clin Nephrol. 2025 Mar;103(3):225-231. doi: 10.5414/CN111640.
Sodium-glucose co-transporter-2 (SGLT-2) inhibitors have been added to the mainstay of treatment for chronic heart failure. Recent studies suggest that empagliflozin may also reverse cardiac remodeling in heart failure by reducing N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. In our study, we wanted to show the decrease in NT-proBNP levels, which is an indicator of poor prognosis in heart failure, and to see if there was a decrease in the rate of renal progression in patients with HF after empagliflozin use.
Patients with type 2 diabetes mellitus and heart failure using empagliflozin were selected from the system and 456 patients were found. Patients were divided into two groups: heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). The patients were divided into two groups according to their NT-proBNP levels at the beginning of the drug and on the 90 day. The laboratory data were analyzed at the time of drug initiation and at day 90.
There was a statistically significant difference between baseline and day 90 HbA1C and NT-proBNP levels (p < 0.001), (p < 0.001). NT-proBNP and creatinine levels at baseline and day 90 were significantly higher in patients with HFrEF than in those with HFpEF (p < 0.001). According to the multivariate analysis, patients with HFrEF were 11.42 times more likely to have an NT-proBNP change above 300 pg/mL than patients with HFpEF (OR: 11.42, p = 0.028).
In our study, a significant reduction in NT-proBNP and HbA1C levels was observed, while renal function was preserved.
钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂已被纳入慢性心力衰竭的主要治疗方案。近期研究表明，恩格列净可能还通过降低N末端B型利钠肽原（NT-proBNP）水平来逆转心力衰竭中的心脏重塑。在我们的研究中，我们想要证实作为心力衰竭预后不良指标的NT-proBNP水平降低情况，并观察使用恩格列净后心力衰竭患者的肾脏疾病进展率是否降低。
从系统中选取使用恩格列净的2型糖尿病合并心力衰竭患者，共找到456例患者。患者分为两组：射血分数保留的心力衰竭（HFpEF）组和射血分数降低的心力衰竭（HFrEF）组。根据患者用药初始时和第90天时的NT-proBNP水平将患者分为两组。在用药开始时和第90天时分析实验室数据。
基线与第90天时的糖化血红蛋白（HbA1C）和NT-proBNP水平存在统计学显著差异（p < 0.001），（p < 0.001）。HFrEF患者基线和第90天时的NT-proBNP和肌酐水平显著高于HFpEF患者（p < 0.001）。根据多变量分析，HFrEF患者NT-proBNP变化超过300 pg/mL的可能性是HFpEF患者的11.42倍（比值比：11.42，p = 0.028）。
在我们的研究中，观察到NT-proBNP和HbA1C水平显著降低，同时肾功能得以保留。
