Effect of empagliflozin on ventricular remodeling in patients with type 2 diabetes mellitus and coronary heart disease

doi:10.3969/j.issn.1004-583X.2021.08.008

Abstract

Abstract:

Objective To investigate the effect of empagliflozin on ventricular remodeling in patients with type 2 diabetes mellitus(T2DM) complicated by coronary heart disease(CHD). Methods A total of 128 patients with T2DM complicated by CHD were randomly divided into two groups, 64 cases in each group. The control group was treated with conventional oral medicine, and the experimental group received empagliflozin on bases of conventional oral medicine, a course for 12 weeks. The experimental indicators were observed, including systolic blood pressure(SBP), diastolic blood pressure(DBP), fasting blood glucose(FBG), 2 h postprandial glucose (2 hPG), glycosylated hemoglobin A₁c(HbA₁c), total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), brain natriuretic peptide(BNP), C-troponin I, creatine kinase-mb(CKMB), left ventricular end diastolic volume(LVEDV), left ventricular end systolic volume(LVESV), left ventricular ejection fraction(LVEF), left ventricular fractional shortening(LVFS), left ventricular end-diastolic diameter(LVEDD), left ventricular end-stage systole diameter(LVESD), interventricular septum(IVS), left ventricular posterior wall(LVPW), Fasting Insulin(FINS), C-peptide, Homeostasis model assessment- β(HOMA-β), Homeostasis Model Assessment of Insulin Resistance(HOMA-IR).Results Compared with before treatment, SBP, DBP, FBG, 2 hPG, HbA₁c, TC, TG, LDL-C, LVEDV, LVESV, LVEDD, LVESD, IVS, LVPW and HOMA-IR in both groups decreased. While LVFS, FINS, C-peptide and HOMA-β increased after treatment (P<0.05). After treatment, SBP, DBP, FBG, 2 hPG, HbA₁c, TC, TG, LDL-C, LVEDV, LVESV, LVEDD, LVESD, IVS, LVPW and HOMA-IR were lower in experimental group than in control group.LVFS, FINS, C-peptide, HOMA-β were higher in experimental group than in control group (P<0.05).Conclusion Empagliflozin can improve ventricular remodeling in patients with T2DM complicated by CHD, which have more advantages compared with conventional hypoglycemic drugs and cardiovascular drugs.

Key words: diabetes mellitus, type 2, coronary disease, ventricular remodeling, clinical laboratory techniques, ultrasonography,Doppler

CLC Number:

Yin Xiaokang, Zhang Jiping, Zhu Yugang, Shen Hongxia, Wang Defeng. Effect of empagliflozin on ventricular remodeling in patients with type 2 diabetes mellitus and coronary heart disease[J]. Clinical Focus, 2021, 36(8): 713-718.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.08.008

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I8/713

Figures/Tables 15

References 20

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组别	例数	性别(例)		年龄 (岁)	体质量指数 (kg/m²)	病程 (年)
组别	例数	男	女	年龄 (岁)	体质量指数 (kg/m²)	病程 (年)
试验组	64	36	28	48±12.48	24.97±3.57	8.56±7.03
对照组	64	34	30	50±11.75	25.16±3.92	8.92±7.64
统计值		χ²=0.032		t=0.285	t=0.179	t=0.862
P值		0.859		0.776	0.858	0.390

组别	例数	性别(例)		年龄 (岁)	体质量指数 (kg/m²)	病程 (年)
组别	例数	男	女	年龄 (岁)	体质量指数 (kg/m²)	病程 (年)
试验组	64	36	28	48±12.48	24.97±3.57	8.56±7.03
对照组	64	34	30	50±11.75	25.16±3.92	8.92±7.64
统计值		χ²=0.032		t=0.285	t=0.179	t=0.862
P值		0.859		0.776	0.858	0.390

组别	例数	BNP(pg/ml)		肌钙蛋白I(μg/L)		CK-MB(U/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	64	105.41±10.13	101.32±11.32	0.14±0.12	0.12±0.06	14.65±5.46	14.16±4.63
试验组	64	108.74±12.94	102.25±10.62	0.13±0.15	0.11±0.04	14.37±5.35	13.82±4.12
t值		0.599	1.246	0.698	1.641	0.156	1.848
P值		0.550	0.215	0.486	0.103	0.876	0.067

组别	例数	BNP(pg/ml)		肌钙蛋白I(μg/L)		CK-MB(U/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	64	105.41±10.13	101.32±11.32	0.14±0.12	0.12±0.06	14.65±5.46	14.16±4.63
试验组	64	108.74±12.94	102.25±10.62	0.13±0.15	0.11±0.04	14.37±5.35	13.82±4.12
t值		0.599	1.246	0.698	1.641	0.156	1.848
P值		0.550	0.215	0.486	0.103	0.876	0.067

组别	例数	LVEDV(ml)				LVESV(ml)				LVEF(%)				LVFS(%)
组别	例数	治疗前		治疗后		治疗前		治疗后		治疗前		治疗后		治疗前		治疗后
对照组	64	123.54±12.69		114.68±13.78^*		64.75±5.65		55.82±6.37^*		62.73±5.64		63.25±4.32		25.35±1. 51		27.18±1.83^*
试验组	64	121.37±15.13		108.94±12.95^*#		62.86±6.49		52.19±5.64^*#		63.35±5.48		64.76±3.86		25.84±1.65		28.79±1.28^*#
t值		1.025		4.169		0.661		5.327		0.854		1.635		1.265		4.386
P值		0.307		0.000		0.510		0.000		0.395		0.105		0.208		0.000
组别	例数	LVEDD(mm)			LVESD(mm)				IVS(mm)				LVPW(mm)
组别	例数	治疗前	治疗后		治疗前		治疗后		治疗前		治疗后		治疗前		治疗后
对照组	64	62.64±3.42	57.93±2.12^*		51.29±4.35		48.13±3.58^*		14.82±0.58		12.32±0.43^*		14.39±0.46		14.03±0.84^*
试验组	64	63.53±5.37	56.71±4.94^*#		52.37±4.71		46.83±3.12^*#		13.68±0.41		10.97±0.75^*#		13.97±0.76		12.56±0.68^*#
t值		0.258	6.137		0.324		5.789		0.166		7.374		0.812		7.842
P值		0.798	0.000		0.746		0.000		8.868		0.000		0.418		0.000