Hypertension:β受体阻滞剂对糖尿病患者心血管事件的影响!

2017-05-31 xing.T MedSci原创

总之,在糖尿病患者中应用β-受体阻滞剂与心血管事件风险增加相关。

虽然β-受体阻滞剂的使用可能有助于达到最大程度的强化血糖控制的效果,因为严重低血糖后的不良反应有所减少,但是其导致了严重低血糖发生的潜在风险。近日,心血管权威杂志Hypertension上发表了一篇研究文章,研究人员旨在评估β受体阻滞剂在糖尿病患者中是否有效,并且其使用是否与严重低血糖的发生有关。

研究人员使用了ACCORD试验(控制糖尿病血管风险试验)的数据,研究人员采用倾向评分调整进行了Cox比例风险分析。该研究的主要结局为研究期间首次发生的心血管事件,包括非致死性心肌梗死、不稳定型心绞痛、非致死性卒中心血管死亡。

研究人员发现接受β-受体阻滞剂治疗患者(n=2527)平均随访了4.7±1.6年,而未采用β受体阻滞剂治疗患者(n=2527)平均随访期为4.6±1.6年。β受体阻滞剂患者的心血管事件发生率显著高于未采用β受体阻滞剂治疗患者(风险比为1.46;95%可信区间为1.24-1.72;P<0.001)。在冠心病或心力衰竭患者中,服用β受体阻滞剂的患者心血管事件累积发生率也显著高于未服用β受体阻滞剂的患者(风险比为1.27;95%可信区间为1.02-1.60;P=0.03)。服用β-受体阻滞剂患者出现严重低血糖的发生率也显著高于未服用β-受体阻滞剂的患者(风险比为1.30;95%可信区间为1.03-1.64;P=0.02)。

总之,在糖尿病患者中应用β-受体阻滞剂与心血管事件风险增加相关。

原始出处:

Tetsuro Tsujimoto,et al. Risk of Cardiovascular Events in Patients With Diabetes Mellitus on β-Blockers.Hypertension. 2017.https://doi.org/10.1161/HYPERTENSIONAHA.117.09259

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content=不错的方式,努力学习,刻苦专研,不断总结出来新经验。, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Jun 01 21:21:34 CST 2017, time=2017-06-01, status=1, ipAttribution=)]
    2017-12-20 zhyy88
  5. 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content=不错的方式,努力学习,刻苦专研,不断总结出来新经验。, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Jun 01 21:21:34 CST 2017, time=2017-06-01, status=1, ipAttribution=)]
    2017-08-17 feather89
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content=不错的方式,努力学习,刻苦专研,不断总结出来新经验。, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Thu Jun 01 21:21:34 CST 2017, time=2017-06-01, status=1, ipAttribution=)]
    2017-06-03 往日如昨

    学习了谢谢分享

    0

  7. 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    2017-06-01 虈亣靌

    不错的方式,努力学习,刻苦专研,不断总结出来新经验。

    0

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JAHA:接受非心脏手术的糖尿病患者到底该怎样服用β受体阻滞剂?

术前30天以上服用心脏保护性β受体阻滞剂才能减少死亡率风险,而短期服用β受体阻滞剂与糖尿病患者死亡率的差异无关。

BMJ:早期使用β受体阻滞剂可降低急性心肌梗死患者30天死亡率

本研究旨在评估早期和长期β受体阻滞剂治疗与急性心肌梗死后死亡率之间的关系. 多中心前瞻性队列研究设计纳入2005年前法国全国急性ST和非ST段抬高心肌梗死(FAST-MI)登记册的患者(223个中心)。 研究最终纳入2679例急性心肌梗死,但无心力衰竭或左室功能不全的患者。 结果,77%(2050 / 2679)的患者早期使用β受体阻滞剂,80%(1783 / 2217)的患者出院时