Int J Cardiol:二甲双胍与2型糖尿病合并急性冠状动脉综合征患者的全因死亡率降低相关

2019-03-14 xing.T 网络

由此可见,在2型糖尿病合并ACS​​患者中,二甲双胍与全因死亡率降低有关。但是,不能排除任何对照药物的不利效应。

尚未报道评估二甲双胍治疗2型糖尿病(DM)合并急性冠状动脉综合征(ACS)患者疗效的随机对照试验。近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,与非二甲双胍抗糖尿病药物使用者相比,研究人员旨在评估二甲双胍治疗2型糖尿病合并ACS​​患者的死亡率。

该研究的数据来自全国范围的ACS-DM台湾心脏病学会登记中心。研究人员对二甲双胍与非二甲双胍使用者进行基线特征和治疗措施的倾向评分(PS)匹配。Cox比例风险模型用于比较PS匹配队列中的死亡率结果作为主要分析。调整总体人群中PS的所有预定协变量和五分位数Cox比例风险模型作为二次分析。

在1157例接受抗糖尿病药物治疗的2型糖尿病合并ACS患者中,78例患者(6.7%)在2年随访期间死亡。PS匹配后,318名二甲双胍服用者与318名非二甲双胍服用者进行匹配。在初步分析中,二甲双胍使用者的全因死亡率较低(校正风险比[aHR]为0.50,95%置信区间[CI]为0.26-0.95)。二甲双胍治疗的生存获益在次要分析中是一致的(调整所有预先确定的协变量aHR为0.30,95%CI为0.17-0.54;调整PS的五分位数aHR为0.34,95%CI为0.19-0.59)。

由此可见,在2型糖尿病合并ACS​​患者中,二甲双胍与全因死亡率降低有关。但是,不能排除任何对照药物的不利效应。

原始出处:


Chien-BoonJong,et al.Metformin was associated with lower all-cause mortality in type 2 diabetes with acute coronary syndrome: A Nationwide registry with propensity score-matched analysis.International Journal of Cardiology.2019.https://doi.org/10.1016/j.ijcard.2019.03.021

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