JAMA Cardiol:2型糖尿病患者使用西他列汀不会增加房颤入院的风险(TECOS研究)

2016-04-16 MedSci MedSci原创

以前试验结果表明,二肽基肽酶4抑制剂(DPP4i)的使用可能会增加2型糖尿病(T2DM)患者的心脏衰竭(HF)的风险。在西他列汀对于心血管预后的评价试验(TECOS)中,试验结果表明,对于一级和二级复合动脉粥样硬化性心血管(CV)的结果,DPP4i西他列汀已经被证明其效果不优于安慰剂。该研究的目的是评估HF入院(hHF)使用西他列汀和相关结果的联系。TECOS是一项随机,双盲,安慰剂对照研究,来自

以前试验结果表明,二肽基肽酶4抑制剂(DPP4i)的使用可能会增加2型糖尿病(T2DM)患者的心脏衰竭(HF)的风险。在西他列汀对于心血管预后的评价试验(TECOS)中,试验结果表明,对于一级和二级复合动脉粥样硬化性心血管(CV)的结果,DPP4i西他列汀已经被证明其效果不优于安慰剂。

该研究的目的是评估HF入院(hHF)使用西他列汀和相关结果的联系。

TECOS是一项随机,双盲,安慰剂对照研究,来自美国德州大学西南医学中心的研究人员评估了西他列汀 vs 安慰剂的CV安全性,西他列汀和安慰剂都加入到常规降糖治疗与2型糖尿病患者的CV护理和动脉粥样硬化性血管疾病的治疗中。平均随访为2.9年。在38个国家673个地点进行。参与者包括14671例2型糖尿病和动脉粥样硬化性血管疾病患者。该研究在2008年12月至2015年3月之间进行。

患者被随机分配接受西他列汀 vs 安慰剂加入到标准护理中。

预先设定的二级分析比较了hHF,hHF或CV死亡,和hHF或整体的全因死亡的复合结果,并在预先设定的亚组中比较。支持性分析包括总hHF事件(第一次加上经常性)和后hHF死亡。Meta分析评估了DPP4i对于hHF和hHF或CV死亡影响。

在14671例患者中,7332例患者被随机分配接受西他列汀,7339例接受安慰剂。西格列汀组和安慰剂组的心力衰竭住院发生率分别为3.1%(n=228)和3.1%(n=229)(未调整的危险比,1.00; 95%CI,0.83-1.19)。西格列汀组(n=345)和安慰剂组(n =347)的总hHF事件也没有差异(未调整的危险比,1.00; 95%CI,0.80-1.25)。后期hHF全因死亡在两组也是类似的(分别为29.8% vs 28.8%),心血管死亡也是如此(22.4% vs 23.1%)。在所有21个因素的亚组分析中,西他列汀对hHF的影响都没有异质性(所有相互作用P>0.10)。来自3项报道的DPP4i CV成果试验hHF结果的Meta分析表明有中度异质性(I2=44.9,P=0.16)。

不论是在整体还是在高危患者群中,西他列汀的使用都不会影响2型糖尿病hHF的风险。

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    2017-02-12 shock_melon
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    2016-04-18 QQ3681cbb4

    文中根本没有提到房颤,题目是不是应为心衰

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1781703, encodeId=a8a41e817033b, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Nov 30 08:44:00 CST 2016, time=2016-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1652150, encodeId=d5f2165215004, content=<a href='/topic/show?id=13d01e24509' target=_blank style='color:#2F92EE;'>#TEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17245, encryptionId=13d01e24509, topicName=TEC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=852f24292001, createdName=shock_melon, createdTime=Sun Feb 12 13:44:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79372, encodeId=d45be9372db, content=文中根本没有提到房颤,题目是不是应为心衰, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/5D342857AD092B3A76B960703290406A/100, createdBy=0ea11714216, createdName=QQ3681cbb4, createdTime=Mon Apr 18 17:21:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383213, encodeId=b14a13832133a, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415984, encodeId=3a19141598457, content=<a href='/topic/show?id=f60890462d4' target=_blank style='color:#2F92EE;'>#西他列汀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90462, encryptionId=f60890462d4, topicName=西他列汀)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37f33125782, createdName=tcm100hq, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1473969, encodeId=527914e39691e, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79223, encodeId=ed8ae92234c, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Sun Apr 17 11:16:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79224, encodeId=f25ee922416, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Sun Apr 17 11:16:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79206, encodeId=d6f5e9206ab, content=很好,希望有更多的循证支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun Apr 17 10:23:00 CST 2016, time=2016-04-17, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1781703, encodeId=a8a41e817033b, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Nov 30 08:44:00 CST 2016, time=2016-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1652150, encodeId=d5f2165215004, content=<a href='/topic/show?id=13d01e24509' target=_blank style='color:#2F92EE;'>#TEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17245, encryptionId=13d01e24509, topicName=TEC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=852f24292001, createdName=shock_melon, createdTime=Sun Feb 12 13:44:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79372, encodeId=d45be9372db, content=文中根本没有提到房颤,题目是不是应为心衰, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/5D342857AD092B3A76B960703290406A/100, createdBy=0ea11714216, createdName=QQ3681cbb4, createdTime=Mon Apr 18 17:21:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383213, encodeId=b14a13832133a, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415984, encodeId=3a19141598457, content=<a href='/topic/show?id=f60890462d4' target=_blank style='color:#2F92EE;'>#西他列汀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90462, encryptionId=f60890462d4, topicName=西他列汀)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37f33125782, createdName=tcm100hq, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1473969, encodeId=527914e39691e, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79223, encodeId=ed8ae92234c, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Sun Apr 17 11:16:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79224, encodeId=f25ee922416, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Sun Apr 17 11:16:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79206, encodeId=d6f5e9206ab, content=很好,希望有更多的循证支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun Apr 17 10:23:00 CST 2016, time=2016-04-17, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1781703, encodeId=a8a41e817033b, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Nov 30 08:44:00 CST 2016, time=2016-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1652150, encodeId=d5f2165215004, content=<a href='/topic/show?id=13d01e24509' target=_blank style='color:#2F92EE;'>#TEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17245, encryptionId=13d01e24509, topicName=TEC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=852f24292001, createdName=shock_melon, createdTime=Sun Feb 12 13:44:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79372, encodeId=d45be9372db, content=文中根本没有提到房颤,题目是不是应为心衰, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/5D342857AD092B3A76B960703290406A/100, createdBy=0ea11714216, createdName=QQ3681cbb4, createdTime=Mon Apr 18 17:21:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383213, encodeId=b14a13832133a, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415984, encodeId=3a19141598457, content=<a href='/topic/show?id=f60890462d4' target=_blank style='color:#2F92EE;'>#西他列汀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90462, encryptionId=f60890462d4, topicName=西他列汀)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37f33125782, createdName=tcm100hq, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1473969, encodeId=527914e39691e, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79223, encodeId=ed8ae92234c, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Sun Apr 17 11:16:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79224, encodeId=f25ee922416, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Sun Apr 17 11:16:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79206, encodeId=d6f5e9206ab, content=很好,希望有更多的循证支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun Apr 17 10:23:00 CST 2016, time=2016-04-17, status=1, ipAttribution=)]
    2016-04-17 李继凯

    文章不错

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1781703, encodeId=a8a41e817033b, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Nov 30 08:44:00 CST 2016, time=2016-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1652150, encodeId=d5f2165215004, content=<a href='/topic/show?id=13d01e24509' target=_blank style='color:#2F92EE;'>#TEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17245, encryptionId=13d01e24509, topicName=TEC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=852f24292001, createdName=shock_melon, createdTime=Sun Feb 12 13:44:00 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79372, encodeId=d45be9372db, content=文中根本没有提到房颤,题目是不是应为心衰, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/5D342857AD092B3A76B960703290406A/100, createdBy=0ea11714216, createdName=QQ3681cbb4, createdTime=Mon Apr 18 17:21:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383213, encodeId=b14a13832133a, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415984, encodeId=3a19141598457, content=<a href='/topic/show?id=f60890462d4' target=_blank style='color:#2F92EE;'>#西他列汀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90462, encryptionId=f60890462d4, topicName=西他列汀)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37f33125782, createdName=tcm100hq, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1473969, encodeId=527914e39691e, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Mon Apr 18 02:44:00 CST 2016, time=2016-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79223, encodeId=ed8ae92234c, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Sun Apr 17 11:16:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79224, encodeId=f25ee922416, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Sun Apr 17 11:16:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=79206, encodeId=d6f5e9206ab, content=很好,希望有更多的循证支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun Apr 17 10:23:00 CST 2016, time=2016-04-17, status=1, ipAttribution=)]
    2016-04-17 李继凯

    值得学习

    0

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    2016-04-17 dhzzm

    很好,希望有更多的循证支持

    0

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