司美格鲁肽注射液对不稳定型心绞痛合并糖尿病患者冠脉介入术预后的影响

Effects of semaglutide on prognosis in patients with diabetes mellitus complicated with unstable angina after percutaneous coronary intervention

目的探讨合并糖尿病的不稳定型心绞痛患者经皮冠状动脉介入治疗后应用司美格鲁肽对患者预后的影响。方法回顾性连续纳入2022年9月1日至2023年3月31日于郑州市心血管病医院确诊为不稳定型心绞痛且合并有糖尿病的178例患者。根据是否应用司美格鲁肽注射液将患者分为观察组即应用司美格鲁肽注射液组(简称司美格鲁肽组)(43例)和对照组(135例)。收集两组患者的基线资料及出院后1、3、6、12个月的空腹血糖、糖化血红蛋白、血脂情况、血压和体质量等。对比两组的基线资料以及两组患者术后心血管不良事件(包括心血管死亡、全因死亡、急性心肌梗死、急性缺血性卒中、再次因不稳定型心绞痛再住院及冠状动脉血运重建在内的复合终点)发生的差异性。结果治疗后,司美格鲁肽组和对照组空腹血糖分别为(6.0±0.9)、(8.5±1.3)mmol/L,糖化血红蛋白两组分别为(6.5±0.7)%、(7.9±0.5)%,BMI分别为(22.8±3.0)、(25.0±2.4)kg/m^(2),收缩压分别为(135.3±9.7)、(141.5±8.3)mmHg,两组比较差异有统计学意义(P<0.05),两组舒张压分别为(84.7±7.7)、(86.6±7.7)mmHg,其中司美格鲁肽组也较基线有所降低,但两组差异无统计学意义。司美格鲁肽组患者在第12个月随访时空腹血糖水平、糖化血红蛋白、血脂和体质量等较基线降低。应用Kapan-Meier法估计临床结局的累积事件发生率得出,在合并糖尿病的不稳定型心绞痛患者应用司美格鲁肽可显著降低主要研究终点事件的发生率(4.7%vs.17.8%,P=0.046)。结论对于冠脉介入治疗术后合并糖尿病的不稳定型心绞痛患者,应用司美格鲁肽组患者可降低介入术后心血管不良事件的发生风险,具有明显的心血管保护作用,且可综合有效的管理冠心病患者血糖、体质量、血压、腹型肥胖等多种心血管疾病高危因素。

Objective To investigate the effect of semaglutide on the prognosis in patients with unstable angina complicated with diabetes after percutaneous coronary intervention.Methods A total of 178 patients with unstable angina complicated with diabetes diagnosed in Zhengzhou Cardiovascular Hospital from September 1,2022 to March 31,2023 were included.The patients were divided into a study group(43 patients)and a control group(135 patients)according to whether they received semiglutide or not.Changes in HbA1c,fasting blood glucose,body weight,blood pressure and blood lipid were observed before and after treatment.Baseline data and differences in postoperative adverse cardiovascular events including cardiovascular death,all-cause death,acute myocardial infarction,acute ischemic stroke,re-hospitalization due to unstable angina,and coronary revascularization were compared between the two groups.Results After 12 weeks of treatment,fasting blood-glucose levels in the study group and the control group were(6.0±0.9),(8.5±1.3)mmol/L,HbA1c levels were(6.5±0.7)%,(7.9±0.5)%,BMI was(22.8±3.0),(25.0±2.4)kg/m^(2),systolic blood pressure was(135.3±9.7),(141.5±8.3)mmHg,respectively,with significant differences(P<0.05 for all comparisons).Diastolic blood pressure showed a trend of improvement(84.7±7.7),(86.6±7.7)mmHg,but there was no statistical difference.Conclu-sions For patients with unstable angina complicated with diabetes after percutaneous coronary intervention,the application of semaglutide can effectively control blood glucose,body weight,systolic blood pressure,and reduce the risk of cardiovascular events.