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Circulation:埃格列净可明显降低2型糖尿病合并动粥硬化心血管病患者心衰相关事件风险

2020-12-16 MedSci原创 MedSci原创

钠-葡萄糖共转运体2抑制剂(SGLT-2i)可减少2型糖尿病患者因心脏衰竭而住院(HHF)的风险。该研究评估了SGLT-2抑制剂埃格列净(ertugliflozin)对于HHF和相关预后的影响。

钠-葡萄糖共转运体2抑制剂(SGLT-2i)可减少2型糖尿病患者因心脏衰竭而住院(HHF)的风险。该研究评估了SGLT-2抑制剂埃格列净(ertugliflozin)对于HHF和相关预后的影响。

VERTIS CV试验是一项双盲、安慰剂为对照的临床试验,将2型糖尿病合并动脉粥样硬化性血管(CV)病的患者随机分组,接受埃格列净 5 mg、15 mg或安慰剂治疗。预定的次要分析是对比各组间首次发生HHF事件的时间和HHF/CV死亡的综合结局。

发生首次事件的时间分析

共8246位患者被随机分组,埃格列净组 5499位、安慰剂组 2747位;其中1958位(23.7%)患者有心衰(HF)病史,5006位(60.7%)患者有试验前的射血分数(EF)资料,包括959位EF≤45%的患者。埃格列净并未能显著降低首次HHF/CV死亡(风险比[HR] 0.88,95% CI 0.75-1.03)。

两个治疗组患者的事件发生情况

总体上,埃格列净降低了首次HHF的风险(HR 0.70,95% CI 0.54-0.90,p=0.006)。HF病史并不影响埃格列净的这种效应(有HF病史 vs 无HF病史的HR:0.63 vs 0.79,p=0.40)。在HF患者中,首次HHF风险降低的程度与EF≤45%的患者的相当。但在总人群中,EF≤45%的患者的风险降低的最明显(HR 0.48,95% CI 0.30-0.76)(EF>45%的患者的HR为0.86)。

首次和总的HHF事件的累积发生率

埃格列净对首次HHF风险的影响在大部分亚组中是一致的,但其中有三类患者受益最明显,分别是基础估计肾小球滤过率<60 mL·min–1·1.73 m–2、蛋白尿和使用利尿剂的患者。埃格列净可降低HHF的总发生率(HR 0.70)和HHF/CV的总死亡率(HR 0.83)。

总之,对于2型糖尿病患者,埃格列净治疗可降低其因心衰而住院的首次和总体风险,以及HHF/CV死亡的风险。该研究结果支持采用钠-葡萄糖共转运体2抑制剂作为HHF的主要和次选预防措施。

原始出处:

Francesco Cosentino, et al. Efficacy of Ertugliflozin on Heart Failure–Related Events in Patients With Type 2 Diabetes Mellitus and Established Atherosclerotic Cardiovascular Disease. Circulation. 2020;142:2205–2215

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    2020-12-16 AA513842754

    学习

    0

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    2020-12-15 misszhang

    谢谢MedSci提供最新的资讯

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1644872, encodeId=fac016448e2eb, content=<a href='/topic/show?id=e3eb89e17fb' target=_blank style='color:#2F92EE;'>#血管病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89717, encryptionId=e3eb89e17fb, topicName=血管病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=64bb23195917, createdName=Luyuxie_17, createdTime=Tue Oct 12 15:15:21 CST 2021, time=2021-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=908740, encodeId=8846908e4098, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09755440345, createdName=AA513842754, createdTime=Wed Dec 16 23:49:26 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043429, encodeId=c7581043429f9, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Tue Dec 15 14:15:21 CST 2020, time=2020-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=908179, encodeId=e1719081e9f1, content=埃格列净并未能显著降低首次HHF/CV死亡<a href='/topic/show?id=4f77e665253' target=_blank style='color:#2F92EE;'>#糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=158, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76652, encryptionId=4f77e665253, topicName=糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210607/9f00a0de660e4b36b77a9a5f7620d6bf/98c22b17ddf7446fa7b9a618fabcb9f7.jpg, createdBy=a8fb2299762, createdName=Psycho.Dr Du, createdTime=Tue Dec 15 13:53:20 CST 2020, time=2020-12-15, status=1, ipAttribution=)]
    2020-12-15 Psycho.Dr Du

    埃格列净并未能显著降低首次HHF/CV死亡#糖尿病#

    0

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