PDF(Pubmed)
Abstract：
BACKGROUND: Heart failure (HF), especially HF with reduced ejection fraction (HFrEF), presents complex challenges, particularly in the aging population where it often coexists with type 2 diabetes mellitus (T2DM).
OBJECTIVE: To analyze the effect of dapagliflozin treatment on cardiac, renal function, and safety in patients with HFrEF combined with T2DM.
METHODS: Patients with T2DM complicated with HFrEF who underwent treatment in our hospital from February 2018 to March 2023 were retrospectively analyzed as the subjects of this study. The propensity score matching method was used, and a total of 102 eligible samples were scaled. The clinical efficacy of the two groups was evaluated at the end of the treatment, comparing the results of blood glucose, insulin, cardiac function, markers of myocardial injury, renal function indexes, and 6-min walk test (6MWT) before and after the treatment. We compared the occurrence of adverse effects on the treatment process of the two groups of patients. The incidence of adverse outcomes in patients within six months of treatment was counted.
RESULTS: The overall clinical efficacy rate of patients in the study group was significantly higher than that of patients in the control group (P = 0.013). After treatment, the pancreatic beta-cell function index, left ventricular ejection fraction, and glomerular filtration rate of patients in the study group were significantly higher than control group (P < 0.001), while their fasting plasma glucose, 2-h postprandial glucose, glycosylated hemoglobin, insulin resistance index, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, cardiac troponin I, creatine kinase-MB, N-terminal pro b-type natriuretic peptide, serum creatinine, and blood urea nitrogen were significantly lower than those of the control group. After treatment, patients in the study group had a significantly higher 6MWT than those in the control group (P < 0.001). Hypoglycemic reaction (P = 0.647), urinary tract infection (P = 0.558), gastrointestinal adverse effect (P = 0.307), respiratory disturbance (P = 0.558), and angioedema (P = 0.647) were not statistically different. There was no significant difference between the incidence of adverse outcomes between the two groups (P = 0.250).
CONCLUSIONS: Dapagliflozin significantly enhances clinical efficacy, cardiac and renal function, and ambulatory capacity in patients with HFrEF and T2DM without an increased risk of adverse effects or outcomes.
OBJECTIVE: To analyze the effect of dapagliflozin treatment on cardiac, renal function, and safety in patients with HFrEF combined with T2DM.
METHODS: Patients with T2DM complicated with HFrEF who underwent treatment in our hospital from February 2018 to March 2023 were retrospectively analyzed as the subjects of this study. The propensity score matching method was used, and a total of 102 eligible samples were scaled. The clinical efficacy of the two groups was evaluated at the end of the treatment, comparing the results of blood glucose, insulin, cardiac function, markers of myocardial injury, renal function indexes, and 6-min walk test (6MWT) before and after the treatment. We compared the occurrence of adverse effects on the treatment process of the two groups of patients. The incidence of adverse outcomes in patients within six months of treatment was counted.
RESULTS: The overall clinical efficacy rate of patients in the study group was significantly higher than that of patients in the control group (P = 0.013). After treatment, the pancreatic beta-cell function index, left ventricular ejection fraction, and glomerular filtration rate of patients in the study group were significantly higher than control group (P < 0.001), while their fasting plasma glucose, 2-h postprandial glucose, glycosylated hemoglobin, insulin resistance index, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, cardiac troponin I, creatine kinase-MB, N-terminal pro b-type natriuretic peptide, serum creatinine, and blood urea nitrogen were significantly lower than those of the control group. After treatment, patients in the study group had a significantly higher 6MWT than those in the control group (P < 0.001). Hypoglycemic reaction (P = 0.647), urinary tract infection (P = 0.558), gastrointestinal adverse effect (P = 0.307), respiratory disturbance (P = 0.558), and angioedema (P = 0.647) were not statistically different. There was no significant difference between the incidence of adverse outcomes between the two groups (P = 0.250).
CONCLUSIONS: Dapagliflozin significantly enhances clinical efficacy, cardiac and renal function, and ambulatory capacity in patients with HFrEF and T2DM without an increased risk of adverse effects or outcomes.
摘要：
背景：心力衰竭（HF），尤其是射血分数降低的HF（HFrEF），提出了复杂的挑战，特别是在老年人群中，它通常与2型糖尿病（T2DM）并存。
目的：分析达格列净治疗心脏,肾功能,HFrEF合并T2DM患者的安全性。
方法：回顾性分析2018年2月至2023年3月在我院接受治疗的T2DM合并HFrEF患者作为研究对象。采用倾向得分匹配法，共102个合格样本进行了缩放。治疗结束后评价两组临床疗效,比较血糖的结果，胰岛素，心功能,心肌损伤标志物，肾功能指标,治疗前后6min步行试验(6MWT)。比较两组患者治疗过程中不良反应的发生情况。统计患者治疗后6个月内不良结局的发生率。
结果：研究组患者临床总有效率明显高于对照组患者(P=0.013)。治疗后,胰腺β细胞功能指数，左心室射血分数,研究组患者的肾小球滤过率明显高于对照组(P<0.001),而他们的空腹血糖，餐后2小时葡萄糖，糖化血红蛋白,胰岛素抵抗指数,左心室收缩末期直径，左心室舒张末期直径，心肌肌钙蛋白I,肌酸激酶-MB，N-末端B型利钠肽原,血清肌酐,血尿素氮明显低于对照组。治疗后,研究组患者的6MWT明显高于对照组(P<0.001)。低血糖反应(P=0.647),尿路感染（P=0.558），胃肠道不良反应(P=0.307),呼吸障碍（P=0.558），血管性水肿（P=0.647）无统计学差异。两组不良结局发生率差异无统计学意义(P=0.250)。
结论：达格列净可显著提高临床疗效，心脏和肾功能，HFrEF和T2DM患者的步行能力和步行能力没有增加不良反应或结局的风险。
目的：分析达格列净治疗心脏,肾功能,HFrEF合并T2DM患者的安全性。
方法：回顾性分析2018年2月至2023年3月在我院接受治疗的T2DM合并HFrEF患者作为研究对象。采用倾向得分匹配法，共102个合格样本进行了缩放。治疗结束后评价两组临床疗效,比较血糖的结果，胰岛素，心功能,心肌损伤标志物，肾功能指标,治疗前后6min步行试验(6MWT)。比较两组患者治疗过程中不良反应的发生情况。统计患者治疗后6个月内不良结局的发生率。
结果：研究组患者临床总有效率明显高于对照组患者(P=0.013)。治疗后,胰腺β细胞功能指数，左心室射血分数,研究组患者的肾小球滤过率明显高于对照组(P<0.001),而他们的空腹血糖，餐后2小时葡萄糖，糖化血红蛋白,胰岛素抵抗指数,左心室收缩末期直径，左心室舒张末期直径，心肌肌钙蛋白I,肌酸激酶-MB，N-末端B型利钠肽原,血清肌酐,血尿素氮明显低于对照组。治疗后,研究组患者的6MWT明显高于对照组(P<0.001)。低血糖反应(P=0.647),尿路感染（P=0.558），胃肠道不良反应(P=0.307),呼吸障碍（P=0.558），血管性水肿（P=0.647）无统计学差异。两组不良结局发生率差异无统计学意义(P=0.250)。
结论：达格列净可显著提高临床疗效，心脏和肾功能，HFrEF和T2DM患者的步行能力和步行能力没有增加不良反应或结局的风险。
