Xin yixue (Aug 2024)
Clinical efficacy of SGLT-2 inhibitor for heart failure after PCI in STEMI patients
Abstract
Objective To evaluate clinical efficacy of early application of sodium-glucose cotransporter-2 （SGLT-2） inhibitors combined with standard therapy for readmission ST-segment elevation myocardial infarction （STEMI） patients complicated with heart failure after percutaneous coronary intervention（PCI）， aiming to provide evidence-based reference for early new drug intervention after PCI. Methods In this retrospective cohort study， STEMI patients complicated with heart failure after PCI admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2019 to January 2023 were enrolled. Among them， 78 patients who were treated with SGLT-2 inhibitors combined with standard treatment were included in the study group， and 92 patients treated with standard treatment alone were assigned in the control group. The changes of cardiac function， clinical efficacy and readmission rate of heart failure before and after corresponding treatment were compared between two groups. Results There was no significant difference in the left ventricular diastolic inner diameter and left ventricular systolic inner diameter between two groups before and after treatment （both P >0.05）. After corresponding treatment， the B-type natriuretic peptide （BNP） level， left ventricular ejection fraction （LVEF） and LVEF difference in the study group were significantly better than those in the control group， and the differences were statistically significant （all P <0.05）. The readmission rates due to heart failure in the study and control groups were 15.4% and 32.6%， and the differences were statistically significant （P <0.05）. Multivariate Cox regression analysis showed the risk of readmission for heart failure in patients receiving standard treatment without SGLT-2 inhibitors was 1.235 times higher than those treated with SGLT-2 inhibitors （HR （95%CI） =2.235（1.094-4.563）， P <0.05）. Conclusions SGLT-2 inhibitors combined with standard therapy can reduce the risk of readmission due to heart failure in STEMI patients with complicated with heart failure after PCI.
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