Circulation:Finerenone(非奈利酮)可改善慢性肾病合并2型糖尿病患者的心血管结局

2021-02-13 MedSci原创 MedSci原创

本文报道了非奈利酮对个体心血管结局以及有无动脉粥样硬心血管疾病(CVD)史的患者的影响。

FIDELIO-DKD试验评估了非甾体选择性盐皮质激素受体拮抗剂Finerenone(非奈利酮)用于采用优化的肾素-血管紧张素系统阻断治疗的慢性肾病合并2型糖尿病的患者对肾脏和心血管的作用。与安慰剂相比,非奈利酮降低了肾和心血管的复合预后。本文报道了非奈利酮对个体心血管结局以及有无动脉粥样硬心血管疾病(CVD)史的患者的影响。

该试验是一项随机、双盲、安慰剂为对照的试验,入组患者条件:罹患2型糖尿病、尿白蛋白/肌酐比值为30-5000 mg/g、肾小球滤过率≥25-<75 mL/min·1.73m2、采用优化的肾素-血管紧张素系统阻断治疗。排除有心衰病史且射血分数降低的患者。复合心血管结局包括到心血管死亡、心肌梗死、卒风或因心衰住院的时间。

2015年9月-2018年6月,共筛选了13911位患者,其中5674位被随机分至两组(1:1);45.9%的患者在基线时有CVD。

复合心血管预后

中位随访2.6年,与安慰剂相比,非奈利酮降低了受试患者的复合心血管结局风险(风险比[HR] 0.86 [95% CI, 0.75–0.99]; P=0.034),且有无CVD的患者之间没有显著的差别。两组需紧急治疗的不良事件的发生率相似,与高钾血症相关的永久停用治疗的发生率较低。

综上,在慢性肾病和2型糖尿病患者中,非奈利酮降低了复合心血管结局的发生率,且无证据表明既往CVD状况对治疗效果有任何影响。

原始出处:

Gerasimos Filippatos, et al. Finerenone and Cardiovascular Outcomes in Patients With Chronic Kidney Disease and Type 2 Diabetes. Circulation. 2021;143:540–552

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    2021-06-08 cenghis
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    2021-02-14 T2DM终结者

    非奈利酮可降低心血管风险

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1968154, encodeId=0783196815490, content=<a href='/topic/show?id=e9a9e45455' target=_blank style='color:#2F92EE;'>#Finerenone#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7454, encryptionId=e9a9e45455, topicName=Finerenone)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=afa4194, createdName=cenghis, createdTime=Tue Jun 08 03:03:20 CST 2021, time=2021-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269377, encodeId=7b9512693e7af, 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=29, 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=Mon Feb 15 06:03:20 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383677, encodeId=daf413836e716, 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=28, 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 Feb 15 06:03:20 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1475039, encodeId=8f7414e5039ac, 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=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Mon Feb 15 06:03:20 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924571, encodeId=7eec9245e1fb, content=非奈利酮可降低心血管风险, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210226/f23705539a22465dad49b185641246f4/269e005bb68348558ceb01a4a8056073.jpg, createdBy=a54d5390453, createdName=T2DM终结者, createdTime=Sun Feb 14 14:06:30 CST 2021, time=2021-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924477, encodeId=cfe99244e7c4, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5afe1476024, createdName=sunyiwarship, createdTime=Sat Feb 13 19:37:33 CST 2021, time=2021-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043510, encodeId=8bab1043510ab, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat Feb 13 18:03:20 CST 2021, time=2021-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924461, encodeId=9e1392446195, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Feb 13 15:37:27 CST 2021, time=2021-02-13, status=1, ipAttribution=)]
    2021-02-13 sunyiwarship

    0

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    2021-02-13 misszhang

    谢谢MedSci提供最新的资讯

    0

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