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

doi:10.3969/j.issn.1006-5725.2024.24.013

Abstract

Abstract:

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/m²， 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. Conclusions 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.

Key words: semaglutide, unstable angina, type 2 diabetes, percutaneous coronary intervention, prognosis

CLC Number:

R541.4

Ziming ZHAO,Qi MA,Jian CHEN,Yuan CHEN,Liuyi CUI,Yujie. ZHAO. Effects of semaglutide on prognosis in patients with diabetes mellitus complicated with unstable angina after percutaneous coronary intervention[J]. The Journal of Practical Medicine, 2024, 40(24): 3515-3520.

Figures/Tables 5

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References 34

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基线资料	观察组（n = 43）	对照组（n = 135）	t/χ2值	P值
年龄（x ± s）/岁	59.4 ± 10.1	62.6 ± 7.1	-1.893	0.064
男性	31（72.1）	99（73.3）	0.025	0.873
体质量（x ± s）/kg	72.7 ± 6.7	71.6 ± 7.9	0.871	0.385
BMI（x ± s）/（kg/m²）	25.9 ± 2.9	25.1 ± 2.4	1.720	0.090
抽烟史	27（62.8）	87（64.4）	0.039	0.844
既往病史
高血压病	34（79.1）	99（73.3）	0.568	0.451
肾功能不全	1（2.3）	0（0）	0.367	0.545
脑梗死	1（2.3）	3（2.2）	0.000	1.000
既往冠脉血运重建史	1（2.3）	6（4.4）	0.030	0.863
心功能不全	1（2.3）	0（0）	0.367	0.545
收缩压（x ± s）/mmHg	139.5 ± 9.3	141.5 ± 8.3	-1.099	0.273
舒张压（x ± s）/mmHg	86.5 ± 7.7	87.1 ± 7.8	-0.407	0.684
实验室指标
空腹血糖（x ± s）/（mmol/L）	8.9 ± 0.9	9.2 ± 1.4	-1.340	0.183
糖化血红蛋白（x ± s）/%	8.0 ± 0.6	8.2 ± 0.5	-1.513	0.132
LDL-C（x ± s）/（mmol/L）	3.7 ± 0.7	3.8 ± 0.4	-1.322	0.192
降糖方案
甘精胰岛素	2（4.7）	12（8.9）	0.329	0.566
二甲双胍	5（11.6）	24（17.8）	0.904	0.342
二甲双胍联合格列美脲	38（88.4）	111（82.2）	0.904	0.342

资料	观察组（n = 43）	对照组（n = 135）	t/χ2值	P值
病变类型
单支病变	5（11.6）	18（13.3）	0.084	0.772
双支病变	7（16.3）	27（20.0）	0.292	0.589
三支病变	31（72.1）	90（66.7）	0.441	0.507
靶血管部位
左主干病变	2（4.7）	3（22.2）	0.096	0.757
前降支病变	15（34.9）	42（31.1）	0.213	0.644
回旋支病变	11（25.6）	42（31.1）	0.477	0.490
右冠病变	15（34.9）	48（35.6）	0.006	0.936
手术策略
支架植入	41（95.3）	129（95.6）	0.000	1.000
单纯药物球囊扩张	2（4.7）	6（4.4）	0.000	1.000
支架数目（x ± s）/个	2.0 ± 0.7	2.1 ± 0.8	-0.859	0.392
支架长度（x ± s）/mm	45.1 ± 12.1	46.6 ± 14.1	-0.605	0.546

资料	观察组（n=43）	对照组（n=135）	t值	P值
体质量/kg	67.3 ± 7.0	71.6 ± 7.7	-3.147	0.001
BMI/（kg/m²）	22.8 ± 3.0	25.0 ± 2.4	-4.504	< 0.001
收缩压/mmHg	135.3 ± 9.7	141.5 ± 8.2	-4.104	< 0.001
舒张压/mmHg	84.7 ± 7.7	86.6 ± 7.7	-1.368	0.173
空腹血糖/（mmol/L）	6.0 ± 0.9	8.5 ± 1.3	-14.136	< 0.001
糖化血红蛋白/%	6.5 ± 0.7	7.9 ± 0.5	-12.958	< 0.001
LDL-C/（mmol/L）	1.7 ± 0.4	1.8 ± 0.4	-1.310	0.192

结局	观察组（n = 43）	对照组（n = 135）	P值
主要随访终点/［例（%）］	2（4.7）	24（17.8）	0.046
心血管死亡	1	2	0.704
全因死亡	0	3	0.309
急性缺血性脑梗死	1	2	0.736
急性心梗	0	4	0.298
因再发不稳定型心绞痛再入院	1	9	0.269
再次血运重建	1	8	0.313

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

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