SGLT-2 抑制剂和心力衰竭患者的死亡率与减少喷射分数:链接数据库研究研究
Henrik Svanström1,2, George Frederick Mkoma3,4, Anders Hviid3,5
1Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark htr@ssi.dk.
BMJ (Clinical research ed.)
|November 6, 2024
概括
-葡萄糖共运输体-2 (SGLT-2) 抑制剂在心力衰竭患者中显著降低了25%的全因死亡率. 这一发现支持在临床实践中使用SGLT-2抑制剂来治疗心力衰竭.
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.
- 临床医学 临床医学
背景情况:
- 减少喷射分数 (HFrEF) 的心力衰竭是死亡的主要原因.
- -葡萄糖共运输体-2 (SGLT-2) 抑制剂是一种越来越多地用于心血管保健的药物类别.
- SGLT-2 抑制剂对HFrEF患者死亡率的影响需要持续调查.
研究的目的:
- 评估SGLT-2抑制剂使用与被诊断患有HFrEF的患者全因死亡率之间的关联.
- 为了比较开始使用SGLT-2抑制剂的患者和没有SGLT-2抑制剂的标准心力衰竭治疗的患者之间的死亡风险.
主要方法:
- 从2020年7月到2023年6月,使用丹麦国家注册表进行链接数据库研究.
- 纳入标准:年龄≥45岁的患者HFrEF (左心室喷射率≤40%).
- 主要结局:全因死亡率. 二次结果:心血管死亡率或心力衰竭住院治疗的综合结果,以及它们的单个组成部分. 使用考克斯回归与治疗权重的逆概率.
主要成果:
- 该研究包括6776名开始使用SGLT-2抑制剂的患者和14686名非使用者.
- 使用SGLT-2抑制剂与全因死亡率减少25%有关 (加权危险比0.75;95% CI 0.66-0.85).
- 对于心血管死亡率或心力衰竭住院治疗的综合结局没有发现显著差异 (加权危险比0.94;95% CI 0.85-1.04).
结论:
- 使用SGLT-2抑制剂与HFrEF患者全因死亡率显著降低有关.
- 这些发现支持SGLT-2抑制剂在管理HFrEF方面的疗效和临床实用性.
- 在患有和没有2型糖尿病的患者中,益处是一致的.
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