Clinical Efficacy and Prognosis of Spironolactone in Patients with Heart Failure with Mildly Reduced Ejection Fraction and Type 2 Diatetes Mellitus
Objective To explore the clinical efficacy and prognosis of spironolactone in patients with heart failure and type 2 diabetes with slightly reduced ejection fraction.Methods A total of 409 patients with heart failure and type 2 diabetes with slightly reduced ejection fraction who were treated in Beijing Chaoyang Hospital from February 2019 to December 2022 were in-cluded.All patients had not taken spironolactone before the trial and had received treatment with other standard heart failure drugs and hypoglycemic drugs for at least six months.Patients will be randomly divided into an experimental group and a con-trol group.The experimental group will receive 10-20 mg/d of spironolactone in addition to the treatment in the control group.The changes in glycated hemoglobin(HbA1c),body mass index,plasma N-terminal B-type natriuretic peptide(NT proB-NP),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),ratio of diastolic peak mitral valve velocity to early mitral annulary(E/e'),serum creatinine(Scr),serum uric acid(SUA),creatinine clearance rate(Ccr),and blood potassium levels between two groups of patients before and after treatment were compared.The incidence of treatment-re-lated adverse reactions,cardiovascular death,or worsening heart failure readmission composite endpoint events were ob-served.Evaluate Clinical treatment efficacy were evaluated.Results There was no statistically significant difference in general information between the two groups of patients before treatment(P＞).05).After treatment,the HbA1c level in the experimen-tal group decreased when compared to the control group[(7.2±0.5)vs.(7.9±0.7),P＜0.05],and the NT proBNP level de-creased when compared to the control group[(423±155)vs.(640±157),P＜0.05].The improvement of various indicators of cardiac and renal function in the experimental group after treatment was better than that in the control group(all P＞0.05).Pa-tients in the experimental group with heart function grades Ⅱ-Ⅳ had relatively stable blood potassium levels during treatment(all P＞0.05).The clinical efficacy and total effective rate of the experimental group after treatment were higher than those of the control group(both P＞0.05),and there was no statistically significant difference in the incidence of composite endpoint e-vents and drug-related adverse reactions between the two groups(P＞0.05).Conclusion Spironolactone is helpful to the blood sugar management of heart failure patients with type 2 diabetes and slightly reduced ejection fraction,and can further improve the heart function and renal function,with satisfying drug safety.
spironolactoneejection fractionheart failuretype 2 diabetesrenal function
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