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JAHA:卡维地洛与美托洛尔对伴有和不伴有2型糖尿病的心衰患者长期死亡率影响的比较

2021-09-17 MedSci原创 MedSci原创

在伴有和不伴有T2D的HFrEF患者当代临床队列中,与美托洛尔相比,卡维地洛与降低长期死亡率无关。然而,卡维地洛与新发T2D风险降低相关,支持卡维地洛比美托洛尔具有更好的代谢特性这一论断。

与美托洛尔相比,卡维地洛可能具有良好的降血糖特性,但在2型糖尿病(T2D)和射血分数降低的心力衰竭(HFrEF)患者中,卡维地洛与美托洛尔相比是否具有更好的死亡率益处尚未明确。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员使用了2010年至2018年期间丹麦的全国数据库,对接受卡维地洛或美托洛尔治疗的新发HFrEF患者的全因死亡率进行了随访,直至2018年底。在HFrEF诊断后120天开始随访,以启动指南定向的药物治疗。

基线时有39260名患者使用卡维地洛或美托洛尔(平均年龄为70.8岁,35%为女性),其中9355名(24%)患者伴有T2D。2989名(32%)T2D患者和10411(35%)名非T2D患者服用了卡维地洛。卡维地洛使用者的房颤患病率较低(20% vs. 35%),但其他特征在各组之间似乎很平衡。到随访结束时,共有11306名(29%)患者死亡。

研究人员观察到卡维地洛和美托洛尔组间的死亡率没有差异,T2D患者的多变量调整风险比(HR)为0.97(0.90-1.05),而没有T2D的患者则为1.00(0.95–1.05),差异P=0.99。与美托洛尔相比,卡维地洛使用者的新发T2D发生率较低;年龄、性别和年份调整后的HR为0.83(0.75-0.91),P<0.0001。
 
在伴有和不伴有T2D的HFrEF患者当代临床队列中,与美托洛尔相比,卡维地洛与降低长期死亡率无关。然而,卡维地洛与新发T2D风险降低相关,支持卡维地洛比美托洛尔具有更好的代谢特性这一论断。

原始出处:

Brian Schwartz.et al.Long‐Term Mortality Associated With Use of Carvedilol Versus Metoprolol in Heart Failure Patients With and Without Type 2 Diabetes: A Danish Nationwide Cohort Study.JAHA.2021.https://www.ahajournals.org/doi/10.1161/JAHA.121.021310

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    2021-10-04 1def6e10m76(暂无匿称)

    #糖尿病#在伴有和不伴有T2D的HFrEF患者当代临床队列中,与美托洛尔相比,卡维地洛与降低长期死亡率无关。然而,卡维地洛与新发T2D风险降低相关,支持卡维地洛比美托洛尔具有更好的代谢特性这一论断。

    0

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createdBy=f0620, createdName=misszhang, createdTime=Fri Sep 17 22:21:22 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052392, encodeId=b4b81052392de, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Sep 17 20:49:08 CST 2021, time=2021-09-17, status=1, ipAttribution=)]
    2021-09-19 zhaohui6731
  4. 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  5. 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  6. 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createdBy=f0620, createdName=misszhang, createdTime=Fri Sep 17 22:21:22 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052392, encodeId=b4b81052392de, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Sep 17 20:49:08 CST 2021, time=2021-09-17, status=1, ipAttribution=)]
    2021-09-18 ms1000002136354097

    学习了

    0

  7. 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createdBy=f0620, createdName=misszhang, createdTime=Fri Sep 17 22:21:22 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052392, encodeId=b4b81052392de, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Sep 17 20:49:08 CST 2021, time=2021-09-17, status=1, ipAttribution=)]
    2021-09-18 谭桂峰

    与美托洛尔相比,卡维地洛可能具有良好的降血糖特性。

    0

  8. 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createdBy=f0620, createdName=misszhang, createdTime=Fri Sep 17 22:21:22 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052392, encodeId=b4b81052392de, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Sep 17 20:49:08 CST 2021, time=2021-09-17, status=1, ipAttribution=)]
    2021-09-17 ms2000000997930621

    真的是学习了

    0

  9. 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createdBy=f0620, createdName=misszhang, createdTime=Fri Sep 17 22:21:22 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052392, encodeId=b4b81052392de, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Sep 17 20:49:08 CST 2021, time=2021-09-17, status=1, ipAttribution=)]
    2021-09-17 misszhang

    谢谢MedSci提供最新的资讯

    0

  10. 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