背景二甲双胍治疗是否会影响2型糖尿病中的SGLT-2抑制剂的心血管结果?

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摘要

即使在高Cardiovascul的存在下,所有患有2型糖尿病患者的一线抗糖尿病药物(Add)已推荐给二甲双胍……

背景二甲双胍治疗是否会影响2型糖尿病中的SGLT-2抑制剂的心血管结果?

< 0.01; I2 = 0.0%), no significant reduction in 3P-MACE was observed with SGLT-2i in presence of background metformin therapy (N = 27,081; HR 0.94; 95% CI, 0.86–1.02; p = 0.13; I2 = 0.0%) with a significant Pheterogenity of 0.03 between the two groups. Similar finding was observed from the pooled results from 4 CVOTs. This may suggest that background metformin therapy may undermine the 3P-MACE benefit of SGLT-2i. However, no such interaction was observed in a recent meta-analysis of SGLT-2i, with or without background metformin therapy. Future research is warranted to understand the CV interaction of metformin with SGLT-2i.

二甲双胍推荐为甚至在2型糖尿病患者的一线抗糖尿病药物(添加)。美国糖尿病协会存在高心血管(CV)风险。相比之下,欧洲的心脏学会建议在高CV风险存在下作为一线加入钠 - 葡萄糖共转运蛋白-2抑制剂(SGLT-2I)或胰高血糖素肽-1受体激动剂。虽然这种不和谐的推荐创造了辩论,但我们试图找到背景二甲双胍治疗是否影响了SGLT-2I的CV结果。从亚组分析中,我们汇集了3点复合主要不良心血管事件(3P-MEACE)的危险比和95%的置信区间根据有或没有背景二甲双胍治疗的结果。随后,我们通过使用随机效应分析应用池对数危险比的逆差方差加权平均值进行了META分析。虽然该荟萃分析发现3P-MACE的显着减少了SGLT-2I,没有背景二甲双胍治疗(n = 7,233; HR 0.79; 95%CI,0.69-0.90; p

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