The value of the Left Ventricular Emission Fraction in Patients with Ischaemic Heart Disease with Diabetes Mellitus 2 in the Assessment of the Effectiveness of Sitagliptin/Metformin

Abstract

IntroductionThe appointment of a DPP 4 inhibitor in patients with СAD and DM 2 with moderate ejection fraction (HFmrEF) continues to be studied. PurposeAnalysis of glycemic parameters in patients with CAD, with DM 2, depending on the phenotype of HF when taking sitagliptin/metformin (S/M). MethodsWe examined 50 patients with CAD with DM 2 at the age of 62.8±1.29 years. Determined fasting glycemia (FG), postprandial (PPG), HbA1c, Echocardiography. Compiled by groups with HFpEF n-33, HFmrEF n-17. Treatment regimen: basic therapy for CAD, S/M). Follow-up for 48 weeks. ResultsIn patients with HFmrEF, we have differences vs the group with HFpEF in the incidence of PCI in history - 58.8 vs 24.2% (χ2=5.752; P=0.017); eGFR<45, ml/min /1,73 m² in 47.0 vs 18.1% (χ2=4.494; P=0.035); duration of DM 2≥8 years (χ2= 6.439; P=0.012). The frequency of myocardial hypokinesis (t=5.824; p=0.016), ASP (t=2.911; p=0.088), and stenosis (t=2.48; p=0.016) was more frequent with HFmrEF. For all parameters of systemic hemodynamics, there is a significant difference in the groups (P=0.0001). In patients with HFpEF, the degree of GN compensation is higher (t=2.501; P=0.01) compared with the HFmrEF group (t=0.981; P=0.404). At 48 weeks, the degree of PPG decline in patients with HFpEF (t=2.476; P=0.03) was more pronounced than in the HFmrEF group (t=1.771; P=0.453). HbA1c showed no significant intergroup differences. ConclusionConclusion. With HFmrEF, the incidence of PCI, eGFR <45, duration of diabetes 2 ≥ 8 years, myocardial hypokinesis is higher. S/M reduces fasting and postprandial glycemia regardless of EF.