SGLT2抑制剂降低2型糖尿病合并心房颤动患者射频消融术后复发的疗效评估  

Evaluation of the efficacy of SGLT2 inhibitors in reducing recurrence after radiofrequency ablation in patients with type 2 diabetes mellitus combined with atrial fibrillation

作　　者：张永红[1] 李志强[1] 程俊华 Zhang Yonghong;LI Zhiqiang;Cheng Junhua(Department of Cardiovascular Medicine,The Sixth Hospital of Shanxi Medical University,Taiyuan,Shanxi 030003;不详)

机构地区：[1]山西医科大学第六医院心血管内科,太原030003

出　　处：《中国循证心血管医学杂志》2024年第12期1502-1505,1511,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的本研究旨在探讨钠-葡萄糖共转运体2抑制剂(SGLT2i)对T2DM患者导管射频消融(CA)术后房性快速性心律失常复发的远期疗效。方法回顾性纳入于山西医科大学第六医院心血管内科接受CA治疗心房颤动的151例2型糖尿病(T2DM)患者。根据患者CA治疗后是否接受SGLT2i治疗,将纳入患者分为SGLT2i组(n=62)和非SGLT2i组(n=89)。收集两组患者基线人口学特征以及药物使用情况,随访2年观察两组患者是否复发房性快速性心律失常,通过单因素Logistic回归筛选与复发结局密切相关的相关因素,多因素Logistic回归调整混杂因素,使用ROC曲线评估SGLT2i治疗对T2MD患者CA术后再复发的影响。结果研究纳入了151例患者,其中SGLT2i治疗组62例,非SGLT2i治疗组89例。与非SGLT2组相比,SGLT2组患者体质指数(BMI)较低(P=0.029),两组其他方面比较,无统计学差异(P>0.05)。随访2年,151例患者中29例复发房性快速性心律失常,与非SGLT2i治疗组相比,SGLT2i治疗组房性快速性心律失常复发率明显降低(8.06%vs.26.97%,P=0.004)。通过多因素分析校准了其他相关因素后,SGLT2i治疗显示出对CA术后出现房性快速性心律失常复发的保护作用(OR=0.20,95%CI:0.06~0.67,P=0.009),ROC曲线的AUC值为0.774(95%CI:0.679~0.870)。结论SGLT2i是T2DM伴心房颤动患者CA术后发生房性快速性心律失常复发的独立危险因素,使用SGLT2i治疗可有效降低CA术后2年内的复发率。Objective The aim of this study was to investigate the long-term efficacy of Sodium-glucose cotransporter 2 inhibitor(SGLT2i)on atrial tachyarrhythmia recurrence after catheter-based radiofrequency ablation(CA)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 151 T2DM patients with atrial fibrillation who received CA in the Cardiovascular Department of the Sixth Hospital of Shanxi Medical University were retrospectively included.Patients were divided into SGLT2i group(n=62)and non-SGLT2I group(n=89)according to whether they received SGLT2i therapy after CA therapy.The baseline demographic characteristics and drug use of patients in the two groups were collected and followed up for 2 years to observe whether the patients in the two groups had recurrent atrial tachyarrhythmia.The relevant factors closely related to the recurrence outcome were screened by univariate Logistic regression,and confounders were adjusted by multivariate Logistic regression.ROC curve was used to evaluate the effect of SGLT2i therapy on recurrence after CA in T2MD patients.Results The study included 151 patients,including 62 patients in the SGLT2i treatment group and 89 patients in the non-SGLT2i treatment group.Patients in the SGLT2 group had a lower body mass index(BMI)than those in the non-SGLT2 group(P=0.029),and there were no statistically significant other differences between the two groups At 2-year follow-up,29 of 151 patients had recurrent atrial tachyarrhythmia,and the recurrence rate of atrial tachyarrhythmia was significantly lower in the SGLT2i group than in the non-SGLT2I group(8.06%vs.26.97%,P=0.004).After calibrating other relevant factors by multifactorial analysis,SGLT2i treatment showed a protective effect against recurrence of atrial tachyarrhythmias occurring after CA(OR=0.20,95%CI:0.06~0.67,P=0.009),and the AUC of the ROC curve was 0.774(95%CI:0.679~0.870).Conclusion SGLT2i is an independent risk factor for atrial tachyarrhythmia recurrence after CA in patients with T2DM with atrial fibrillation,and tr

关 键 词：心房颤动 导管射频消融 钠-葡萄糖共转运体2抑制剂 2型糖尿病 

分 类 号：R541.75[医药卫生—心血管疾病]