Effects of dapagliflozin on glucose metabolism and cardiac function in patients with acute myocardial infarction complicated with diabetes mellitus after percutaneous coronary intervention
Objective To explore the effects of dapagliflozin on glucose metabolism,cardiac function and readmission rate in patients with acute myocardial infarction complicated with diabetes mellitus after percutaneous coronary intervention(PCI).Methods 108 patients with acute myocardial infarction complicated with type 2 diabetes mellitus were enrolled as the study subjects,and were divided into observation group(n=55)and control group(n=53)by the random number table method.The control group was treated with routine antiplatelet drugs and hypoglycemic drugs after PCI,while the observation group was given dapagliflozin on the basis of the control group.After 3 months of treatment,the treatment efficacy,readmission rate,vascular restenosis rate and the incidence rate of adverse cardiac events were compared between the 2 groups.Cardiac function indicators[N-terminal pro-B-type natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)],glucose metabolism indicators[fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPBG),glycosylated hemoglobin(HbAlc)]and inflammatory factors[myeloperoxidase(MPO),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]in the 2 groups were observed before and after treatment.Results The total effective rates of treatment in observation group and control group were 92.73%and 81.13%.There was no statistically significant difference between the 2 groups.After treatment,the NT-proBNP level in observation group was lower than that in control group[(237.31±20.59)pg·mL-1 vs.(251.68±21.17)pg·mL-1],and the LVEF was higher than that in control group[(58.04%±3.12%)vs.(56.97%±3.65%)],while the LVEDD was lower than that in control group[(52.70±5.09)mm vs.(55.05±4.37)mm](P<0.05).The levels of FBG and 2 hPBG and HbAlc value in observation group were lower than those in control group[(5.14±0.69)mmol·L-1 vs.(5.68±0.71)mmol·L-1,(8.01±1.65)mmol·L-1 vs.(8.79±1.39)mmol·L-1,(6.45%±0.69%)vs.(7.04%±0.81%),P<0.05].The levels of MPO,IL-6 and TNF-α were lower in observation group than in control group(P<0.05),and the readmission rate was lower than in control group(1.82%vs.11.32%,P<0.05).There was no significant difference in the rate of vascular restenosis and the incidence rate of adverse cardiac events between the 2 groups(0 vs.7.55%,3.64%vs.13.21%,P>0.05).Conclusion Dapagliflozin can reduce the blood glucose indicators and readmission rate and improve the cardiac function in patients with acute myocardial infarction complicated with diabetes mellitus after PCI.
NETL
NSTL
万方数据
维普
