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Circulation：服用钠葡萄糖协同转运蛋白2抑制剂的心血管结局和风险！

2017-11-14 xing.T MedSci原创

SGLT2i心血管结局风险
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在这个高风险人群中，服用SGLT2i与较低的ACM、HHF和MACE以及较高的BKA风险相关。该研究结果强调了服用SGLT2i潜在的好处和风险。目前尚不清楚的是，BKA风险是否可以扩大到这类药物，因为该研究不足以对个体之间的治疗进行比较。

临床试验显示钠葡萄糖协同转运蛋白2抑制剂(SGLT2i)具有心血管益处和潜在的风险。试验可能对单个终点或安全问题评估能力有限。近日，心血管领域权威杂志Circulation上发表了一篇研究文章，研究人员在2013年4月1日至2016年12月31日期间对来自于美国国防部军事卫生系统的新近服用降糖药物（AHAs）且伴有心血管疾病的2型糖尿病患者进行了一项以人群为基础的队列研究。

研究人员采用条件Cox模型比较了SGLT2i新用户与其他AHAs患者首次全因死亡率的复合终点（ACM）和心力衰竭住院治疗（HHF）事件、主要不良心血管事件（MACE定义为ACM、非致死性心肌梗死和非致命性卒中）以及个别终点的发病率、风险比（HR）和95%可信区间（CI）。探索性安全终点是膝以下截肢（BKA）。

在倾向匹配后，25258名患者中位随访时间为1.6年。与非SGLT2i使用者相比，服用SGLT2i与较低的ACM和HHF发生率（1.73 vs. 3.01次事件每100人每年；HR为0.57；95%CI为0.50-0.65）和MACE（2.31 vs. 3.45次事件每100人每年；HR为0.67，95%CI为0.60-0.75）。服用SGLT2i也与BKA风险增加约2倍相关（0.17 vs. 0.09次事件每100人每年；HR为1.99，95%CI为1.12-3.51）。由于数据库中服用达格列净不成比例，大多数截肢主要发生在服用达格列净的患者中。在处理分析中得到的结果一致。

在这个高风险人群中，服用SGLT2i与较低的ACM、HHF和MACE以及较高的BKA风险相关。该研究结果强调了服用SGLT2i潜在的好处和风险。目前尚不清楚的是，BKA风险是否可以扩大到这类药物，因为该研究不足以对个体之间的治疗进行比较。

原始出处：

Jacob A. Udell,et al. Cardiovascular Outcomes and Risks After Initiation of a Sodium Glucose Co-Transporter 2 Inhibitor: Results From the EASEL Population-Based Cohort Study. Circulation.2017. https://doi.org/10.1161/CIRCULATIONAHA.117.031227

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    2018-05-06 12498ebem19暂无昵称

    #葡萄糖协同转运蛋白2#

    0

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    2018-09-12 yzh409

    #转运#

    0

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    2018-09-22 jklm09

    #抑制剂#

    0

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    2018-04-17 liuquan

    #2抑制剂#

    0

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    2017-11-26 虈亣靌

    学习一下谢谢分享

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1811483, encodeId=0e281811483a9, content=<a href='/topic/show?id=80cb8824855' target=_blank style='color:#2F92EE;'>#葡萄糖协同转运蛋白2#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88248, encryptionId=80cb8824855, topicName=葡萄糖协同转运蛋白2)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Sun May 06 20:08:00 CST 2018, time=2018-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1696301, encodeId=786e1696301ad, content=<a href='/topic/show?id=0107934e0a5' target=_blank style='color:#2F92EE;'>#转运#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93470, encryptionId=0107934e0a5, topicName=转运)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47c429881595, createdName=yzh409, createdTime=Wed Sep 12 05:08:00 CST 2018, time=2018-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1851570, encodeId=e42b18515e06d, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Sep 22 19:08:00 CST 2018, time=2018-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995502, encodeId=9f791995502a2, content=<a href='/topic/show?id=992411149e' target=_blank style='color:#2F92EE;'>#2抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1114, encryptionId=992411149e, topicName=2抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28b7142, createdName=liuquan, createdTime=Tue Apr 17 19:08:00 CST 2018, time=2018-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264387, encodeId=ab2926438eab, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sun Nov 26 07:30:26 CST 2017, time=2017-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269322, encodeId=9c901269322bf, content=<a href='/topic/show?id=49d1518915a' target=_blank style='color:#2F92EE;'>#心血管结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51891, encryptionId=49d1518915a, topicName=心血管结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a9987, createdName=gous, createdTime=Wed Nov 15 23:08:00 CST 2017, time=2017-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261446, encodeId=954126144694, content=好好看下.内容丰富, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Wed Nov 15 13:22:57 CST 2017, time=2017-11-15, status=1, ipAttribution=)]
    2017-11-15 gous

    #心血管结局#

    0

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    2017-11-15 虈亣靌

    好好看下.内容丰富

    0