静脉铁疗法在收缩性心力衰竭患者接受SGLT2抑制剂的临床结果
Waleed Alruwaili1, Syed Ahmad1, Seher Berzingi1
1Department of Medicine, West Virginia University, Morgantown, West Virginia.
The American journal of cardiology
|June 8, 2025
概括
-葡萄糖携带载体-2 抑制剂 (SGLT2i) 可能会影响铁水平. 结合SGLT2抑制剂和静脉注射铁在心力衰竭患者的铁缺乏症增加了血栓栓塞事件,死亡率和心力衰竭恶化的风险.
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.
- 生物化学 生物化学
背景情况:
- -葡萄糖携带载体-2 抑制剂 (SGLT2i) 可以改变铁的生物标志物,可能模仿铁缺乏症 (ID).
- 静脉注射 (IV) 铁是心力衰竭 (HF) 中ID的标准治疗方法,但其与SGLT2i的安全性尚未得到充分证实.
- 静脉铁和SGLT2i在患有ID的缩性HF患者之间的相互作用需要对血栓栓塞栓事件 (TE) 风险进行调查.
研究的目的:
- 评估静脉铁疗法和SGLT2i联合治疗缩性HF和ID患者的风险.
- 评估联合治疗与血栓栓塞事件,主要不良心血管事件 (MACE),全因死亡率和HF恶化的关联.
主要方法:
- 对TrinetX数据库的回顾性分析.
- 在SGLT2i上确定了患有缩性HF的患者,并诊断出ID (血清费里丁<100μg/L).
- 倾向性得分匹配用于平衡群体; 考克斯比例危险比率计算为1年后续结果.
主要成果:
- 在16660名患者中,3434人接受了静脉铁疗法.
- 静脉铁治疗与TE (HR: 1.56),MACE (HR: 1.51),所有原因死亡率 (HR: 1.55) 和HF恶化 (HR: 1.41) 的风险显著增加有关.
- 这些关联的p值分别为p=0.001,p=0.007,p<0.001和p=0.003.
结论:
- 结合IV铁疗法和SGLT2抑制剂在患有ID的缩性HF患者中显著增加TE,MACE,死亡率和HF恶化的风险.
- 需要进一步的机制研究来了解IV铁和SGLT2i之间的相互作用.
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