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BRIDGE-DS研究:评估达格列净/西格列汀联合用药在2型糖尿病合并心力衰竭患者中的有效性和安全性。

BRIDGE-DS study: evaluating the effectiveness and safety of dapagliflozin/sitagliptin combination in type 2 diabetes mellitus patients with heart failure.

作者信息

Kumar Kandanat Purushothaman Nair Suresh, Variam Manikandan Thiruvanath, S Bala Vignesh, Nath Kshitiz, Goyal Kailash Kumar, Beswal Gaurav, Arun Prashanth, Narayan Kiran, Kumar S P Sathish, Ravindranath V, Tripathy Nishant, Kalra Bharat Kumar, Ray Pranabes, Garg Pooja, Laul Anil, Dhand Sunil, Kamat Sajal, Kesarkar Rohan Narayan, Prasad Ashish, Pednekar Abhijit

机构信息

Department of Cardiology, Kauvery Hospital Chennai, Chennai, Tamil Nadu.

Department of Cardiology, Elite Mission Hospital, Thrissur, Kerala.

出版信息

Cardiovasc Endocrinol Metab. 2025 Sep 3;14(4):e00334. doi: 10.1097/XCE.0000000000000334. eCollection 2025 Dec.

Abstract

BACKGROUND

Co-occurrence of type 2 diabetes mellitus (T2DM) and heart failure (HF) elevates the risk of morbidity and mortality. Recent research emphasizes treatment strategies that go beyond glycemic control to enhance heart function.

AIM

To assess the effectiveness and safety of the fixed-drug combination of dapagliflozin and sitagliptin (FDC D/S) in T2DM patients with HF.

METHODS

This was a retrospective, multicenter, observational study that included data from 168 T2DM patients with HF receiving treatment with FDC D/S. Outcome parameters included glycated hemoglobin (HbA), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), hypertension, N-terminal pro-B-type natriuretic peptide (NT-proBNP), estimated glomerular filtration rate (eGFR), and adverse events.

RESULTS

The mean age of the patients was 55.5 ± 10.5 years. Most patients had comorbidities such as hypertension (86.3%) and dyslipidemia (75%), with more than 53% being obese. A significant ( < 0.0001) reduction was observed in HbA, FPG, PPG, and NT-proBNP levels, and in systolic blood pressure (SBP) and diastolic blood pressure (DBP) after 3 months of treatment with FDC D/S, while a significant ( < 0.0001) increase was observed in ejection fraction and eGFR, indicating improved glycemic control and heart function. Urinary tract infections (29.8%), dehydration (17.9%), hypoglycemia (14.9%), and genital mycotic infection (6.6%) were the common adverse events encountered with FDC D/S.

CONCLUSION

FDC D/S enhances glycemic control in T2DM patients with HF, leading to reductions in HbA, FPG, PPG, and cardiovascular risk factors such as NT-proBNP, SBP, and DBP, while also improving eGFR. The FDC D/S was generally well-tolerated, making it an effective and convenient treatment option.

摘要

背景

2型糖尿病(T2DM)与心力衰竭(HF)并存会增加发病和死亡风险。近期研究强调治疗策略应超越血糖控制以增强心脏功能。

目的

评估达格列净与西格列汀固定剂量复方制剂(FDC D/S)在T2DM合并HF患者中的有效性和安全性。

方法

这是一项回顾性、多中心观察性研究,纳入了168例接受FDC D/S治疗的T2DM合并HF患者的数据。观察指标包括糖化血红蛋白(HbA)、空腹血糖(FPG)、餐后血糖(PPG)、高血压、N末端B型利钠肽原(NT-proBNP)、估算肾小球滤过率(eGFR)以及不良事件。

结果

患者的平均年龄为55.5±10.5岁。大多数患者患有高血压(86.3%)和血脂异常(75%)等合并症,超过53%的患者肥胖。在接受FDC D/S治疗3个月后,HbA、FPG、PPG和NT-proBNP水平以及收缩压(SBP)和舒张压(DBP)均显著降低(<0.0001),而射血分数和eGFR显著升高(<0.0001),表明血糖控制和心脏功能得到改善。尿路感染(29.8%)、脱水(17.9%)、低血糖(14.9%)和生殖器真菌感染(6.6%)是FDC D/S常见的不良事件。

结论

FDC D/S可改善T2DM合并HF患者的血糖控制,使HbA、FPG、PPG以及NT-proBNP、SBP和DBP等心血管危险因素降低,同时提高eGFR。FDC D/S总体耐受性良好,是一种有效且便捷的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd05/12410316/d85a0428d278/xce-14-e00334-g001.jpg

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