左心室功能,堵塞和empagliflozin对心肌梗塞后心力衰竭风险的影响
Jacob A Udell1, Mark C Petrie2, W Schuyler Jones3
1Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
Journal of the American College of Cardiology
|April 8, 2024
概括
恩帕格利弗洛辛显著减少了急性心肌梗塞 (AMI) 后的心力衰竭住院的病例,无论左心室喷射率 (LVEF) 或拥堵. 这一发现为治疗AMI后患者使用empagliflozin提供了新的见解.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 已知empagliflozin在急性心肌梗塞 (AMI) 后使用可以减少心力衰竭 (HF) 住院.
- 然而,在这种情况下,其对所有原因死亡率的影响仍然不清楚.
- 左心室喷射分数 (LVEF) 和拥堵对结果和empagliflozin疗效的影响需要进一步评估.
研究的目的:
- 评估LVEF严重程度,拥堵或两者之间的关联,以及AMI后患者的结果.
- 确定empagliflozin在这些患者中减轻HF风险的有效性.
- 分析Empagliflozin在不同LVEF和拥堵子组中的影响.
主要方法:
- 在EMPACT-MI试验中,在14天内随机选择了6,522名AMI患者,他们减少了LVEF (<45%) 或对empagliflozin或安慰剂的拥堵.
- 患者的随访时间中位数为17.9个月,以评估HF住院和死亡率.
- 根据基线LVEF,拥堵的存在和治疗臂,分析了结果.
主要成果:
- 较低的LVEF和拥堵的存在独立地与所有原因死亡,首次HF住院和总HF住院的风险显著增加有关.
- 恩帕格利弗洛辛在首次HF住院患者 (HR:0.77) 和总HF住院患者 (RR:0.67) 中显著减少.
- 无论基线LVEF或拥堵状况如何,在所有子组中均可观察到这些好处,且安全性概况相似.
结论:
- 在AMI后的患者中,受损的LVEF和拥堵是不良结果的显著预测因素.
- 恩帕格利弗洛辛有效地减少了AMI患者的HF住院,包括那些减少LVEF和/或拥堵的患者.
- 药物的安全性概况在这个人群中不同LVEF和拥堵水平上保持一致.
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