-葡萄糖共运输体-2 抑制剂和心律失常:对38项随机对照试验的元分析
Vikash Jaiswal1, Song Peng Ang2, Danisha Kumar3
1Department of Cardiovascular Research, Larkin Community Hospital, South Miami, Florida, USA.
JACC. Advances
|February 22, 2025
概括
-葡萄糖共传输体-2 抑制剂 (SGLT2i) 降低了2型糖尿病,心力衰竭或脏疾病患者心房律乱和突然心脏死亡 (SCD) 的风险. 然而,SGLT2i并没有显示出心室心律失常的风险降低.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- -葡萄糖共传输体-2 抑制剂 (SGLT2i) 已被认为可以减少心力衰竭住院和心血管死亡率.
- 对于SGLT2i对心律失常和突然心脏死亡 (SCD) 的影响仍然不太清楚.
研究的目的:
- 调查SGLT2i使用与心律失常和SCD风险之间的关联.
- 分析2型糖尿病,心力衰竭或慢性病患者的数据.
主要方法:
- 在PubMed,EMBASE和Scopus数据库中进行了系统的文献搜索.
- 包括到2023年2月10日发表的相关随机对照试验 (RCT).
- 使用随机效应模型进行了聚合分析,以计算赔率比率 (OR) 和95%置信区间 (CI).
主要成果:
- 这项研究包括38个RCT,涉及88,704名患者,平均跟踪时间为1.6年.
- SGLT2i显著降低了发生性心房律乱 (OR:0.85,P=0.02) 和SCD (OR:0.72,P=0.02) 的风险.
- 在心室节律失常 (OR:1.03,P=0.77) 或心脏骤停 (OR:0.94,P=0.67) 的风险上没有发现显著差异.
结论:
- 在患有2型糖尿病和/或HF或CKD的患者中,SGLT2i治疗与心房律乱和SCD的风险较低有关.
- 在被研究的人群中,SGLT2i治疗没有显示出心室心律失常的风险降低.
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