SGLT-2抑制剂治疗STEMI患者PCI术后合并心力衰竭的效果观察OACSTPCD
Clinical efficacy of SGLT-2 inhibitor for heart failure after PCI in STEMI patients
目的 探讨早期应用钠-葡萄糖协同转运蛋白 2(SGLT-2)抑制剂联合标准治疗对ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入(PCI)术后合并心力衰竭患者再住院的影响,为PCI术后早期新药干预提供循证依据.方法 采用回顾性队列研究方法,收集 2019 年 1 月至 2023 年 1 月新疆维吾尔自治区人民医院收治的STEMI PCI术后合并心力衰竭的患者.将以SGLT-2 抑制剂联合标准治疗的 78 例患者纳入研究组,92 例予以标准治疗者纳入对照组,比较 2 组患者治疗前后心功能变化、临床疗效以及心力衰竭再住院率.结果 治疗前后 2 组患者的左室舒张期内径、左室收缩期内径比较,差异均无统计学意义(P均>0.05).研究组治疗后B型利钠肽、左心室射血分数(LVEF)及治疗前后LVEF差值优于对照组,差异均有统计学意义(P均<0.05).研究组与对照组因心力衰竭再住院发生率分别为 15.4%和 32.6%,差异有统计学意义(P<0.05).多因素Cox回归分析显示,未服用SGLT-2 抑制剂的标准治疗患者的因心力衰竭再住院风险比服用SGLT-2 抑制剂的患者高 1.235 倍[HR(95%CI)=2.235(1.094～4.563),P<0.05].结论 SGLT-2 抑制剂联合标准治疗能降低STEMI PCI术合并心力衰竭患者因心力衰竭再住院风险.
Objective To evaluate clinical efficacy of early application of sodium-glucose cotransporter-2(SGLT-2)inhibitors combined with standard therapy for readmission ST-segment elevation myocardial infarction(STEMI)patients complicated with heart failure after percutaneous coronary intervention(PCI),aiming to provide evidence-based reference for early new drug intervention after PCI.Methods In this retrospective cohort study,STEMI patients complicated with heart failure after PCI admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2019 to January 2023 were enrolled.Among them,78 patients who were treated with SGLT-2 inhibitors combined with standard treatment were included in the study group,and 92 patients treated with standard treatment alone were assigned in the control group.The changes of cardiac function,clinical efficacy and readmission rate of heart failure before and after corresponding treatment were compared between two groups.Results There was no significant difference in the left ventricular diastolic inner diameter and left ventricular systolic inner diameter between two groups before and after treatment(both P>0.05).After corresponding treatment,the B-type natriuretic peptide(BNP)level,left ventricular ejection fraction(LVEF)and LVEF difference in the study group were significantly better than those in the control group,and the differences were statistically significant(all P<0.05).The readmission rates due to heart failure in the study and control groups were 15.4%and 32.6%,and the differences were statistically significant(P<0.05).Multivariate Cox regression analysis showed the risk of readmission for heart failure in patients receiving standard treatment without SGLT-2 inhibitors was 1.235 times higher than those treated with SGLT-2 inhibitors(HR(95%CI)=2.235(1.094-4.563),P<0.05).Conclusions SGLT-2 inhibitors combined with standard therapy can reduce the risk of readmission due to heart failure in STEMI patients with complicated with heart failure after PCI.
阿卜杜如苏力·喀迪尔;李杰;王钊
新疆维吾尔自治区人民医院 新疆心脏血管稳态与再生医学研究实验室,新疆 乌鲁木齐 830001
钠-葡萄糖协同转运蛋白2抑制剂心力衰竭ST段抬高型心肌梗死经皮冠状动脉介入再住院风险
Sodium-glucose cotransporter-2 inhibitorHeart failureST-segment elevation myocardial infarctionPercutaneous coronary interventionReadmission risk
《新医学》 2024 (008)
624-630 / 7
2023年度"天山英才"医药卫生高层次人才培养计划(TSYC202301A012)
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