心力衰竭,萨克萨利普丁和糖尿病:来自SAVOR-TIMI 53随机试验的观察结果
Benjamin M Scirica1, Eugene Braunwald2, Itamar Raz2
1From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division (B.M.S., E.B., M.A.C., D.A.M., K.I., A.A.U.-E., D.L.B.) and Department of Pathology (P.J.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Diabetes Unit (I.R., O.M.), Division of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel; Cardiovascular Division (J.A.U.), Women's College Hospital and Toronto General Hospital, University of Toronto, Toronto, Canada; AstraZeneca Research and Development (P.S.P., B.H.), Gaithersburg, MD; Bristol-Myers Squibb (R.F.), Princeton, NJ; Cardiovascular Research Institute (B.S.L.), Lady Davis Carmel Medical Center and Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Cardiovascular Medicine (D.K.M.) and Division of Endocrinology, Department of Internal Medicine (J.D.), University of Texas Southwestern Medical Center, Dallas, TX; University Hospital Department (G.S.), Département Hospitalo-Universitaire FIRE (Fibrosis, Inflammation, Remodelling), Institut National de la Santé et de la Recherche Médicale (INSERM) Unit 1148, Université Paris-Diderot, and Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France (P.G.S.), Imperial College, Institute of Cardiovascular Medicine and Science, Royal Brompton Hospital, London, UK. bscirica@partners.org.
在2型糖尿病患者中,萨克萨格利平因心力衰竭而增加住院治疗. 这种风险在患有心力衰竭,脏疾病或尿酸水平升高的人群中最高.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 糖尿病和心力衰竭经常同时存在.
- 很少有糖尿病试验前性地评估了心力衰竭作为终点.
研究的目的:
- 为了评估萨克萨格利普丁对心力衰竭在2型糖尿病患者住院治疗的影响.
- 确定患有心力衰竭住院风险较高的患者子组.
主要方法:
- 16,492名2型糖尿病和心血管风险患者被随机分配给萨克萨格利普丁或安慰剂.
- 平均随访时间为2.1年;主要终点是心血管死亡,心肌梗塞或缺血性中风.
- 住院治疗心力衰竭是次要终点;测量了N-终端亲B型性尿素.
主要成果:
- 萨克萨格利普丁组的心力衰竭住院率较高 (3.5%对2.8%;HR,1.27;P=0.007).
- 风险在早期升高 (1.9%与12个月后的1.3%相比;HR,1.46;P=0.002),后来没有显著差异.
- 在患有先前心力衰竭,eGFR ≤60毫升/分钟或升高的N终端亲B型尿素的患者中观察到的最高风险.
结论:
- 萨克萨格利普丁治疗增加了因心力衰竭住院的风险.
- 这种增加的风险在患有高尿酸,先前心力衰竭或慢性病的患者中最为明显.
相关概念视频
Heart Failure III: Clinical Manifestations
Heart Failure Drugs: β-Blockers
Heart Failure V: Medical Management
Dipeptidyl Peptidase 4 Inhibitors
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
Heart Failure Drugs: Diuretics

