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与慢性脏病相关的复合心血管风险的可修改性 在2型糖尿病中使用芬瑞
Rajiv Agarwal1, Bertram Pitt2, Peter Rossing3,4
1Richard L. Roudebush VA Medical Center and Indiana University, Indiana University School of Medicine, Indianapolis.
JAMA cardiology
|June 14, 2023
概括
在患有2型糖尿病和慢性病的患者中,芬瑞治疗可能会降低心血管风险. 这种药物可以在人口层面每年预防许多心血管事件,特别是在那些高EGFR的人群中.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
背景情况:
- 心血管疾病 (CVD) 是2型糖尿病 (T2D) 和慢性病 (CKD) 患者的主要死亡原因.
- 在T2D中,CKD相关心血管风险的可变性仍然是积极调查的领域.
研究的目的:
- 为了研究芬瑞在改变T2D和CKD患者心血管风险方面的疗效.
- 估计芬瑞龙治疗对预防心血管事件的影响.
主要方法:
- 进行了对FIDELIO-DKD和FIGARO-DKD试验 (FIDELITY) 的综合分析.
- 数据与国家健康和营养检查调查数据相结合,以模拟人口层面的事件预防.
- 对心血管事件发生率的分析是基于估计的淋巴细胞过率 (eGFR) 和专性尿症类别.
主要成果:
- 较低的eGFR和较高的白蛋白尿与心血管事件发生率的增加有关.
- 费内伦显著降低了复合心血管风险 (HR,0.86;95% CI,0.78-0.95).
- 模拟表明,一年的芬瑞治疗可以预防符合条件的个体超过38000次心血管事件.
结论:
- 费内伦治疗似乎在T2D患者中修改了CKD相关的心血管风险.
- 在各种eGFR和albuminuria层中观察到芬瑞的益处.
- 尿中的白蛋白与肌素比率 (UACR) 查可以识别那些可能从芬瑞治疗中显著受益的患者.
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