Effect of dapagliflozin on the prognosis of patients with diabetes mellitus and acute coronary syndrome
Li Jiaying
Jin Qun
Zhong Ping
Zhong Weiwei
Yin Min
Wang Zheng
Han Shufang
Abstract：Objective To analyze the effect of dagliflozin on the prognosis of elderly patients with acute coronary syndrome(ACS)combined with type 2 diabetes mellitus(T2DM).Methods Eighty elderly patients diagnosed with ACS combined with T2DM in the Department of Cardiology of the 960th Hospital of the People's Liberation Army of the Joint Logistics Support Force from January 2019 to June 2021 were included in the study.They were randomly divided into the observation group(n=40)and the control group(n=40).The observation group was discharged from the hospital with the sodium-glucose co-transporter protein 2 inhibitor(SGLT2i)drug dagliflozin(oral,10 mg,1 time/day)or in combination with other glucose-lowering medications(metformin,oral,500 mg,2 times/day;glycosidase inhibitors(acarbose),oral,50 mg,3 times/day;glargine(glarginezide extended-release tablets),oral,90 mg,1 time/day;DPP-4 inhibitor(viglitin),oral,50 mg,2 times/day;insulin,subcutaneous,0.2 U/kg·day),and a control group discharged from the hospital on glucose-lowering medications other than SGLT2i(metformin,oral,500 mg,2 times/day;glucosidase inhibitor(acarbose),oral 50 mg,3 times/day;glinides(gliclazide extended-release tablets),oral,90 mg,1 time/day;DPP-4 inhibitors(vinogliptin),oral,50 mg,2 times/day;and insulin,subcutaneous,0.2 U/kg·day),and all patients were followed up for 1 year.The primary clinical information,cardiac function indexes,cardiovascular outcomes and complications of the two groups were statistically compared at the end of the follow-up of all patients.Results The differences between the two groups were not statistically significant when comparing age at admission,gender,body mass index(BMI),smoking,systolic blood pressure,diastolic blood pressure,heart rate,duration of diabetes mellitus,history of chronic disease,ACS typing,blood biochemical indexes,and echocardiographic indexes(P>0.05).In comparing inpatient treatment programs,cardiovascular medication,and hypoglycemic medication between the two groups of patients,the differences were also not statistically significant(P>0.05).The incremental BMI,incremental systolic blood pressure,incremental fasting blood glucose,incremental glycated hemoglobin,incremental plasma N-terminal brain natriuretic peptide precursor,and incremental left ventricular end-systolic internal diameter of the patients in the observation group decreased compared with that of the control group(P<0.05),In contrast,the incremental estimated glomerular filtration rate and the incremental left ventricular ejection fraction increased compared with that of the control group,and the difference was statistically significant(P<0.05).The incidence of death from cardiovascular causes and non-fatal myocardial infarction,and the rate of re-hospitalization due to heart failure and angina pectoris were lower in the observation group than in the control group,and the difference was statistically significant(P<0.05).The incidence of severe hypoglycemia in the follow-up of patients in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Dagliflozin can improve the prognosis of elderly patients with ACS combined with T2DM,reduce heart failure and angina rehospitalization,and have high safety.
Keywords：DagliflozinElderlyACST2DM
Publication Date：2024-05-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 602-606,618 )