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使用 SGLT2 抑制剂可降低心力衰竭和住院风险:一项多中心真实世界证据研究。

Use of SGLT2 Inhibitors Reduces Heart Failure and Hospitalization: A Multicenter, Real-World Evidence Study.

机构信息

Indiana University School of Medicine, Indianapolis, IN, USA.

Indiana Clinical & Translational Sciences Institute (CTSI), IU School of Medicine-Evansville, Evansville, IN, USA.

出版信息

Perm J. 2023 Mar 15;27(1):77-87. doi: 10.7812/TPP/22.137. Epub 2023 Mar 13.

Abstract

Background New research has produced evidence to support the use of diabetic drugs to prevent heart failure (HF). However, evidence of their effect in real-world clinical practice is limited. Objective The objective of this study is to establish whether real-world evidence supports clinical trial findings that use of sodium-glucose cotransporter-2 inhibitor (SGLT2i) reduces rate of hospitalization and incidence of HF for patients with cardiovascular disease and type 2 diabetes. Methods This retrospective study used electronic medical records to compare rate of hospitalization and incidence of HF among 37,231 patients with cardiovascular disease and type 2 diabetes under treatment with SGLT2i, glucagon-like peptide-1 receptor agonist (GLP1-RA), both, or neither. Results Significant differences were found between medication class prescribed and number of hospitalizations (p < 0.0001) and incidence of HF (p < 0.0001). Post-hoc tests revealed reduced incidence of HF in the group treated with SGLT2i relative to GLP1-RA alone (p = 0.004) or neither of these key drugs (p < 0.001). No significant differences were observed between the group receiving both drug classes compared to SGLT2i alone. Discussion Results of this real-world analysis are consistent with clinical trial findings that SGLT2i therapy reduces incidence of HF. The findings also suggest the need for further points of research in demographic and socioeconomic status differences. Conclusion Real-world evidence supports clinical trial findings of SGLT2i reducing both incidence of HF and rate of hospitalization.

摘要

背景

新的研究提供了证据支持使用糖尿病药物来预防心力衰竭(HF)。然而,关于其在实际临床实践中的效果的证据有限。

目的

本研究旨在确定真实世界的证据是否支持临床试验的发现,即使用钠-葡萄糖共转运蛋白 2 抑制剂(SGLT2i)可降低心血管疾病和 2 型糖尿病患者的住院率和 HF 发生率。

方法

本回顾性研究使用电子病历比较了 37231 例接受 SGLT2i、胰高血糖素样肽-1 受体激动剂(GLP1-RA)、两者或两者均不治疗的心血管疾病和 2 型糖尿病患者的住院率和 HF 发生率。

结果

所开药物种类和住院次数(p<0.0001)以及 HF 发生率(p<0.0001)之间存在显著差异。事后检验显示,与 GLP1-RA 单药治疗(p=0.004)或不使用这两种关键药物(p<0.001)相比,SGLT2i 治疗组 HF 发生率降低。同时接受两种药物治疗的组与单独使用 SGLT2i 的组之间未观察到显著差异。

讨论

真实世界分析的结果与临床试验的发现一致,即 SGLT2i 治疗可降低 HF 的发生率。这些结果还表明需要进一步研究人口统计学和社会经济地位差异方面的问题。

结论

真实世界的证据支持 SGLT2i 降低 HF 发生率和住院率的临床试验发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0428/10013722/e8adaf719a3a/tpp_22.137-g001.jpg

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