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

2022-08-07 MedSci原创 MedSci原创

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。

血管疾病在2型糖尿病和慢性肾脏疾病(CKD)患者中很常见。CKD增加了与心血管疾病相关的发病率和死亡率。在卡格列净和肾事件在糖尿病肾病临床评估(CREDENCE)试验中,钠-葡萄糖同向转运体2抑制剂卡格列净降低了首次心血管复合事件的风险。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,在这项事后分析中,研究人员评估了卡格列净对总心血管事件(首次和复发)的影响。

CREDENCE试验在4401例2型糖尿病、蛋白尿、估计肾小球滤过率为30-90 mL/min/1.73m2的患者中比较了卡格列净与匹配的安慰剂的疗效,受试者平均随访时间为2.6年。该研究的主要结局分析为任何心血管事件的综合结局,包括心肌梗死卒中、因心衰住院、因不稳定心绞痛住院和心血管死亡。研究人员采用负二项回归模型评估卡格列净对心血管事件净负担的影响。

在试验中,634例患者发生883例心血管事件,其中472例(74%)仅发生1例心血管事件,162例(26%)发生多种心血管事件。卡格列净将首次心血管事件发生率减少了26%(风险比为0.74 [95%CI为0.63-0.86];P<0.001),总心血管事件发生率减少了29%(发生率比为0.71[95%CI为0.59-0.86];P<0.001)。在2.5年的治疗时间里,每1000名患者首次心血管事件的绝对风险差值为- 44 (95%CI为- 67至- 21)和总事件为-73 (95%CI为-114至-33)。

由此可见,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。

原始出处:

Jing‐Wei Li.et al.Effect of Canagliflozin on Total Cardiovascular Burden in Patients With Diabetes and Chronic Kidney Disease: A Post Hoc Analysis From the CREDENCE Trial.JAHA.2022.https://www.ahajournals.org/doi/10.1161/JAHA.121.025045

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    2022-08-08 zhaohui6731
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    2022-08-07 yangchou

    好文章,谢谢分享。

    0

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