JACC:非奈利酮可有效降低糖尿病合并慢性肾病患者的房颤发生率

2021-05-28 Nebula MedSci原创

在CKD合并T2D的患者中,非奈利酮治疗降低了新发AFF的风险,无论基线时有无AFF病史

心房颤动(房颤,AF)是最常见的持续性心律失常,发病率不断升高,极大地增加了卒中和心力衰竭的风险。慢性肾病(CKD)和2型糖尿病(T2D)患者由于心室重构和肾脏并发症发生房颤/房扑(AFF)的风险增加

Finerenone(非奈利酮)是一种新型的选择性非甾体盐皮质激素受体拮抗剂,在临床前模型中表现出抑制心室重构的作用。

本研究旨在通过分析FIDELIO-DKD试验(3期试验,评估了非奈利酮用于糖尿病肾病患者减少肾衰和疾病进展的效果)受试患者的AFF病史,研究非奈利酮对新发AFF和心肾效应的影响。

CKD合并T2D的患者随机(1:1)接受非奈利酮或安慰剂治疗。受试患者的尿白蛋白/肌酐比值:30~5,000 mg/g,肾小球滤过率(eGFR):25~75 ml/min/1.73 m2,并在接受优化剂量的肾素-血管紧张素系统阻断治疗。通过AFF病史分析主要复合结局(肾衰竭、eGFR较基线持续下降≥40%或肾性死亡)和关键次要结局(心血管死亡、非致死性心肌梗死、非致死性卒中或因心衰住院)。

两组新发AFF的累积发生率

在5674位患者中,461位(8.1%)有AFF病史,非奈利酮组新发AFF 82例(3.2%),安慰剂组新发AFF 117例(4.5%)(风险比 0.71;95%CI 0.53-0.94;p=0.016)。非奈利酮对主要和关键次要肾脏和心血管预后的影响不受基线AFF的显著影响(交互作用p值分别为0.16和0.85)。

总结图

综上,在CKD合并T2D的患者中,非奈利酮治疗降低了新发AFF的风险,无论基线时有无AFF病史,肾脏和心血管事件的风险都有所降低。

原始出处:

Filippatos Gerasimos,Bakris George L,Pitt Bertram et al. Finerenone Reduces Onset of Atrial Fibrillation in Patients with Chronic Kidney Disease and Type 2 Diabetes. J Am Coll Cardiol, 2021, undefined: undefined. https://doi.org/10.1016/j.jacc.2021.04.079

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    2021-07-30 hbwxf
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    2021-10-13 ms5776555236220877

    0

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    2021-06-16 大叔默默路过

    不错的药物

    0

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  8. [GetPortalCommentsPageByObjectIdResponse(id=1826695, encodeId=c2ee1826695b0, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Thu Mar 31 01:24:30 CST 2022, time=2022-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854937, encodeId=2676185493e96, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Fri Jul 30 15:24:30 CST 2021, time=2021-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1059982, encodeId=6e17105998282, content=棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib092ccJZ9Rl31q516IV1eMcGNeOlTEgbotAy5bWjOCk9tN0lxxuWCWzRZXGfFiaK7dAgJicNPAb47uAiaJuEBnyhiam/0, createdBy=85352099100, createdName=ms5776555236220877, createdTime=Wed Oct 13 00:33:12 CST 2021, time=2021-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025902, encodeId=6c2d202590290, content=<a href='/topic/show?id=a91d82583bf' target=_blank style='color:#2F92EE;'>#肾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82583, encryptionId=a91d82583bf, topicName=肾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db5b227, createdName=gostraight, createdTime=Thu Jan 06 23:24:30 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055986, encodeId=fea820559867d, content=<a href='/topic/show?id=d088536467a' target=_blank style='color:#2F92EE;'>#慢性肾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53646, encryptionId=d088536467a, topicName=慢性肾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Fri May 06 05:24:30 CST 2022, time=2022-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974015, encodeId=5e039e4015f8, content=不错的药物, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210427/b594a756d77e4171b5313e531ef89b43/31c000a8a97d4872b698c80fb8a33369.jpg, createdBy=624b2152505, createdName=大叔默默路过, createdTime=Wed Jun 16 09:36:28 CST 2021, time=2021-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326800, encodeId=eb70132680061, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun May 30 07:24:30 CST 2021, time=2021-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031393, encodeId=caa510313939c, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Fri May 28 19:24:30 CST 2021, time=2021-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043617, encodeId=7b4c104361eb8, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Fri May 28 19:24:30 CST 2021, time=2021-05-28, status=1, ipAttribution=)]
    2021-05-28 心介

    房颤,临床上碰到很多哦

    0

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    2021-05-28 misszhang

    谢谢MedSci提供最新的资讯

    0

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