Cardiovasc Diabetol:卡格列净治疗可显著改善T2DM+心衰患者的心衰状态

2022-08-14 MedSci原创 MedSci原创

卡格列净治疗合并 T2DM 的 HF 患者可改善过量的胰岛素超负荷,有助于改善其临床心衰状态

2 型糖尿病 (T2DM) 患者的胰岛素抵抗和高胰岛素血症与心力衰竭 (HF) 的发展和恶化呈负相关。在此,研究人员试图研究卡格列净对合并 T2DM 的 HF 患者胰岛素浓度的影响以及胰岛素浓度变化与 HF 相关临床参数的相关性。

本文是对关于 T2DM 和慢性 HF 患者的、多中心、开放标签、随机、对照 CANDLE 试验的事后分析。该试验的主要终点是24周时卡格列净治疗相比格列美脲治疗的效果、对胰岛素水平的影响,以及胰岛素水平变化与 HF 相关临床参数变化的相关性。

在 CANDLE 试验受试者中,共有129位(卡格列净组 64位,格列美脲组 65位)是非胰岛素使用者,且有基线和24周时的血清胰岛素水平数据,被纳入本次分析。总体上,受试患者的平均年龄是69.0±9.4岁;75%的男性;平均HbA1c是6.8±0.7%;平均左心室射血分数是59.0±14.1%,两个治疗组之间的参数大致平衡。


两治疗组胰岛素水平的变化

24周时,卡格列净治疗显著降低了胰岛素水平(p<0.001),卡格列净组和格列美脲组的差值是-3.52 mU/L(95% CI -4.85~-2.19; p<0.001)。无论基线胰岛素水平如何,胰岛素浓度的降低都与接受卡格列净治疗的患者的 NYHA 分级改善显著相关。

综上,该研究结果表明,卡格列净治疗合并 T2DM 的 HF 患者可改善过量的胰岛素超负荷,有助于改善其临床心衰状态。

 

原始出处:

Tanaka, A., Imai, T., Shimabukuro, M. et al. Association between serum insulin levels and heart failure-related parameters in patients with type 2 diabetes and heart failure treated with canagliflozin: a post-hoc analysis of the randomized CANDLE trial. Cardiovasc Diabetol 21, 151 (2022). https://doi.org/10.1186/s12933-022-01589-3

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    2023-03-29 docwu2019
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    2022-12-23 quxin068
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    2022-08-29 循证小兵

    #卡格列净#治疗可显著改善#T2DM#+#心衰#患者的心衰状态#糖尿病#

    0

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糖尿病影响心脏新证据!JACC重磅:控糖不佳或使心衰风险升高超6倍!

总体而言,当前这项研究的分析结果证实,对于心衰前临床分期的老年人群而言,糖尿病控制不佳与心衰进展的风险显著升高有关。

JAHA:卡格列净对糖尿病和慢性肾脏疾病患者心血管总负荷的影响

卡格列净可减少心血管事件,对总心血管事件的绝对好处大于首次心血管事件。这些结果进一步支持了在首次心血管事件后继续使用卡格列净治疗以预防心血管事件复发。

积极推行“体医融合和非医疗健康干预”,《运动联合营养缓解2型糖尿病的专家共识》发布!

该专家共识通过检索国际、国内常用电子数据库,参考英国牛津循证医学中心的证据水平进行分级,结合我国正在积极推行“体医融合和非医疗健康干预”的国情,制定了符合中国特色的运动疗法。

Cardiovasc Diabetol:糖化ACE2可降低糖尿病患者心脏中RAS系统抑制的抗重构作用

实现严格的血糖控制可使 RAS 抑制的抗重构作用正常化