Effect of early application of a sodium-glucose cotransporter-2 inhibitor on ventricular remodelling and prognosis in patients with anterior wall acute myocardial infarction
Fangyuan Chen, Ping Liu, Ling Bai, Juanli Li, Tao Chen
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Abstract
Background
The role of sodium-glucose cotransporter-2 inhibitors in patients with acute myocardial infarction remains elusive.
Aim
To evaluate the effect of early application of a sodium-glucose cotransporter-2 inhibitor on ventricular remodelling and prognosis in patients with anterior wall acute myocardial infarction.
Methods
In this prospective study, 102 patients diagnosed with anterior wall acute myocardial infarction were enrolled and divided into intervention and control groups according to the use of dapagliflozin within 24 hours after admission. Demographic and clinical data, including age, sex, associated co-morbidities, number of lesions, length of hospital stay, N-terminal prohormone of brain natriuretic peptide, left ventricular ejection fraction, left ventricular end-systolic and end-diastolic diameters and drug-related adverse reactions, were collected and analysed between the two groups. All patients were followed up 1, 3 and 6 months after discharge.
Results
At 6 months, left ventricular ejection fraction was higher (55.98 ± 7.17% vs. 52.71 ± 7.78%; P = 0.03) and N-terminal prohormone of brain natriuretic peptide was lower (141.52 ± 83.18 vs. 203.69 ± 152.13 pg/mL; P = 0.01) in the intervention group versus the control group. Left ventricular end-systolic diameter (35.68 ± 4.32 vs. 38.00 ± 5.01 mm; P = 0.01) and left ventricular end-diastolic diameter (50.48 ± 4.90 vs. 52.67 ± 4.91 mm; P = 0.03) were smaller in the intervention group versus the control group. Event-free survival rates were better in the intervention group than in the control group (90% vs. 74.5%; P = 0.03). The cumulative incidence of drug-related adverse reactions was similar in the two groups (14% vs. 4.0%; P = 0.15).
Conclusions
Use of dapagliflozin within 24 hours after admission can improve cardiac function, inhibit ventricular remodelling, improve clinical prognosis and have high safety in patients with anterior wall acute myocardial infarction during 6-month follow-up.
背景：钠-葡萄糖共转运蛋白-2抑制剂在急性心肌梗死患者中的作用尚不明确。目的：探讨早期应用钠-葡萄糖共转运蛋白-2抑制剂对前壁急性心肌梗死患者心室重构及预后的影响。方法：本前瞻性研究纳入102例诊断为前壁急性心肌梗死的患者，根据入院后24小时内达格列净的使用情况分为干预组和对照组。收集两组患者的人口学和临床资料，包括年龄、性别、相关合并症、病变数、住院时间、脑利钠肽n端原激素、左心室射血分数、左心室收缩末期和舒张末期直径以及药物相关不良反应。出院后1、3、6个月随访。结果：6个月时左室射血分数高于对照组(55.98±7.17% vs. 52.71±7.78%；P=0.03)，脑利钠肽n端原激素较低(141.52±83.18∶203.69±152.13pg/mL；P=0.01)。左室收缩末期内径（35.68±4.32 vs. 38.00±5.01mm）；P=0.01)，左室舒张末期内径(50.48±4.90∶52.67±4.91mm；P=0.03)，干预组较对照组更小。干预组的无事件生存率优于对照组(90% vs. 74.5%；P = 0.03)。两组药物相关不良反应的累积发生率相似(14% vs. 4.0%；P = 0.15)。结论：入院后24h内应用达格列净可改善前壁急性心肌梗死患者心功能，抑制心室重构，改善临床预后，6个月随访安全性高。
期刊介绍：
The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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