Investigating the Effects of Dapagliflozin on Cardiac Function, Inflammatory Response, and Cardiovascular Outcome in Patients with STEMI Complicated with T2DM after PCI.

Liming Xue,Xia Zhao,Shuguang Zhang,Xian Yuan

doi:10.1155/2021/9388562

Abstract

Objective To explore the effect of dapagliflozin on cardiac function, inflammation, and cardiovascular outcome in patients with ST-segment elevation myocardial infarction (STEMI) combined with type 2 diabetes (T2DM) after percutaneous coronary intervention (PCI). Methods 70 patients with STEMI and T2DM were divided into the control group (n = 35) and the observation group (n = 35). Before surgery, patients in both groups were given conventional treatments such as coronary expansion, antiplatelet, anticoagulation, and thrombolysis, and PCI was performed. After the operation, both groups were given conventional antiplatelet, anticoagulation, lipid-lowering, and hypoglycemic treatments. On this basis, the observation group was treated with dapagliflozin tablets for 24 weeks. We observe and compare the left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF), myocardial enzyme spectrum, inflammatory reaction, and occurrence of adverse cardiovascular events (MACE) of the two groups of patients before and after treatment. Results After treatment, the LVEDD and LVESD of the two groups were lower than those before treatment, and the observation group was lower than the control group (P < 0.05). The LVEF of both groups was higher than that before treatment, and the observation group was higher than the control group (P < 0.05). After treatment, the levels of two groups' patients' creatine kinase (CK), creatine kinase isoenzyme (CK-MB), and troponin I (cTnI) were all lower than those before treatment, and the observation group patients were all lower than the control group (P < 0.05). After treatment, the levels of serum myeloperoxidase (MPO), C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α) in the two groups were all lower than those before treatment, and the observation group patients were all lower than the control group (P < 0.05). After treatment, there was no statistical difference between the two groups of patients in cardiogenic death, recurrent myocardial infarction, and other adverse cardiovascular events (P > 0.05). But, the incidence of severe arrhythmia and heart failure in the observation group were both lower than those in the control group (P < 0.05). Kaplan–Meier survival curve analysis showed that the median survival time without MACE in the observation group was higher than that in the control group (P < 0.05). Conclusion Dapagliflozin treatment for patients with STEMI combined with T2DM after PCI can improve cardiac function to certain extent, reduce inflammation, and will reduce the incidence of adverse cardiovascular outcomes.

Highlights

ST-segment elevation myocardial infarction (STEMI) refers to coronary atherosclerosis that forms thrombosis and causes lumen obstruction, which causes acute and persistent coronary artery ischemia and hypoxia
Drug thrombolytic therapy can greatly increase the risk of important organ bleeding in STEMI patients with Type 2 diabetes mellitus (T2DM), and percutaneous coronary intervention (PCI) can quickly recanalize infarct-related artery (IRA) and restore myocardial blood supply that it is an effective method to efficiently save the dying myocardium in patients with STEMI and T2DM and has important clinical significance for restoring the patient’s left heart function and reducing the occurrence of heart failure
SPSS 22.0 software was used for processing, measurement data were expressed as mean± standard deviation (x ±s), the t-test was used for comparison, count data were expressed by (%), and the χ2 test was used for comparison. e Kaplan–Meier survival curve was used to fit the occurrence of MACE events. e log-rank test was used to compare the incidence of MACE between the two groups

Summary

Introduction

ST-segment elevation myocardial infarction (STEMI) refers to coronary atherosclerosis that forms thrombosis and causes lumen obstruction, which causes acute and persistent coronary artery ischemia and hypoxia. It often manifests as severe pain in the precordial area for more than 30 minutes and a sense of dying, and the ST segment of the electrocardiogram is obviously elevated [1]. Drug thrombolytic therapy can greatly increase the risk of important organ bleeding in STEMI patients with T2DM, and percutaneous coronary intervention (PCI) can quickly recanalize infarct-related artery (IRA) and restore myocardial blood supply that it is an effective method to efficiently save the dying myocardium in patients with STEMI and T2DM and has important clinical significance for restoring the patient’s left heart function and reducing the occurrence of heart failure. PCI is currently a common clinical treatment for STEMI

Methods

Results

Conclusion