糖尿病と糖尿病のない心不全で左心室排泄分子を保存したエンパグリフロジン
Gerasimos Filippatos1, Javed Butler2,3, Dimitrios Farmakis4
1National and Kapodistrian University of Athens School of Medicine, Athens University Hospital Attikon, Greece (G.F.).
Circulation
|June 28, 2022
まとめ
エムパグリフロジンは,糖尿病状態に関係なく,心不全でエジェクション分子が保存されている患者に有益です. このSGLT2阻害剤は,糖尿病患者と非糖尿病患者の両方で,心不全の入院と心血管疾患による死亡を一貫して減少させました.
科学分野:
- 心臓病科
- 内分泌学
- 薬理学について
背景:
- HFpEF (保存されたエジェクション分数を持つ心不全) は,世界中で何百万もの患者を抱えています.
- 糖尿病はHFpEF患者でよくある併発症です.
- 異なる血糖状態におけるHFpEFにおけるSGLT2阻害剤の有効性は,明確にする必要がある.
研究 の 目的:
- 糖尿病と糖尿病のない患者のHFpEF結果に対するエムパグリフロジンの効果を調査する.
- 血糖スペクトルにおけるエンパグリフロジンの効果の一貫性を評価する.
主な方法:
- EMPEROR- 保存試験 (NCT03057951) の事前分析が行われました.
- HFpEF (LVEF> 40%) の患者は,エンパグリフロジン10 mgまたはプラセボを投与された.
- サブグループ分析では,初期糖尿病状態に基づいてアウトカムを比較した.
主要な成果:
- 糖尿病状態に関係なく,エンパグリフロジンは主要なアウトカム (HF入院またはCV死亡) を有意に減少させた (Pinteraction=0. 92).
- 糖尿病患者と非糖尿病者のグループでは,全HF入院とeGFR減少の利点は一貫していました.
- エムパグリフロジン群では低血糖症のリスクは増加しなかった.
結論:
- エムパグリフロジンは,糖尿病状態に関係なく,HFpEF患者における心不全の減少に一貫した有効性を示しています.
- これらの発見は,幅広いHFpEF患者の治療選択肢としてエンパグリフロジンの使用を支持する.
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