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在 CARMELINA 中,林格利普丁对心力衰竭和相关结局的影响
Darren K McGuire1, John H Alexander2, Odd Erik Johansen3
1University of Texas Southwestern Medical Center, Dallas (D.K.M., R.D.T.).
Circulation
|December 28, 2018
概括
在患有2型糖尿病和心血管或脏疾病的患者中,林格利平没有增加心力衰竭 (HF) 的住院治疗. 来自CARMELINA试验的这一发现提供了关于使用linagliptin的HF风险的保证.
科学领域:
- 心脏病学
- 内分泌学
- 肝脏病学
背景情况:
- 2型糖尿病 (T2DM) 显著增加心力衰竭 (HF) 的风险,特别是与同时存在的动脉样性心血管疾病 (ASCVD) 或脏疾病.
- 某些双酶-4 (DPP-4) 抑制剂引起了有关HF风险的担忧.
- 林格利平是用于治疗T2DM的DPP-4抑制剂.
研究的目的:
- 在T2DM和ASCVD和/或脏疾病患者中评估林格利普丁与安慰剂对HF的影响和相关结果.
- 在CARMELINA试验中对高血压住院 (hHF) 和心血管结果进行二次分析.
主要方法:
- 随机,双盲,安慰剂对照试验 (CARMELINA) 涉及6979名患有T2DM和ASCVD和/或脏疾病的参与者.
- 参与者每天服用5毫克林格利平或安慰剂,作为标准治疗的补充.
- 对HF住院情况,心血管事件和死亡情况进行了前性记录,并以中央方式进行判断;分析使用了Cox比例风险和负二项模型.
主要成果:
- 与安慰剂相比,林格利平没有显著影响hHF的发生率 (HR,0. 90;95% CI,0. 74-1. 08).
- 对于心血管死亡/ 心血管衰竭的综合值没有显著差异 (HR,0. 94; 95% CI,0. 82-1. 08).
- 在不同组中,复发性hHF事件的风险也相似 (率比,0. 94;95% CI,0. 75-1. 20).
结论:
- 在患有T2DM和ASCVD和/ 或病的患者中,林格利平没有增加HF住院的风险.
- 林格利普丁对HF风险的影响在各个小组中一致,包括有HF病史,功能变化或基线左心室排泄率的患者.
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