在AKI期间SGLT2i治疗及其与重大脏不良事件的关联
Luz Alcantar-Vallin1,2, Jose J Zaragoza3, Bladimir Díaz-Villavicencio1,2
1Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Frontiers in pharmacology
|June 27, 2024
概括
在急性损伤 (AKI) 患者中,-葡萄糖共运输体2抑制剂 (SGLT2is) 并没有影响重大脏不良事件 (MAKE). 然而,在AKI期间,特定的患者亚组可能会从SGLT2i治疗中受益.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
背景情况:
- 在急性损伤 (AKI) 患者中,-葡萄糖共运输体2抑制剂 (SGLT2is) 对重大脏不良事件 (MAKE) 的影响尚不清楚.
- 了解这种关联对于优化AKI管理和患者结果至关重要.
研究的目的:
- 调查SGLT2抑制剂在急性损伤期间的使用与重大不良事件发生率之间的关联.
- 分析SGLT2抑制剂对特定MAKE成分的影响,并确定可能受益的患者子组.
主要方法:
- 进行了一项回顾性队列研究,涉及374名患有AKI的患者.
- 患者根据住院期间的SGLT2抑制剂治疗 (n=58) 与没有治疗 (n=316) 进行了分类.
- 用近邻匹配的后勤回归来分析SGLT2i使用与MAKE在10天和30-90天的关联.
主要成果:
- 使用SGLT2抑制剂与MAKE10 (或1.08) 或MAKE30-90 (或0.76) 的风险增加无关.
- 在接受SGLT2抑制剂治疗的患者中观察到死亡风险降低 (OR 0.08),对置换疗法 (KRT) 没有显著影响.
- 受益于SGLT2i治疗的子组包括老年患者 (>61岁),EGFR>81的患者,以及没有高血压或糖尿病病史的个人.
结论:
- 在AKI期间使用SGLT2抑制剂并没有显著影响短期或中期重大脏不良事件.
- 某些患者亚组,包括老年人和患有特定并发症的患者,在AKI的背景下可能会从SGLT2抑制剂治疗中获益.
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