Effect Of Dapagliflozin On Cardiac Function And Stent Resten Osis In Patients With Type 2 Diabetes After PCI

Objective:To Observation the effects of dapagliflozin on cardiac function and liver and kidney function and stent restenosis after percutaneous coronary intervention in patients with acute coronary syndrome complicated with type 2 diabetes mellitus,and to identification of patients with type 2 diabetes of stent restenosis occurred after primary percutaneous coronary interention(PCI)risk factors.Methods:From January 2018 to June 2020,select 89 patients with T2DM who received PCI treatment in the First Affiliated Hospital of Zhengzhou University due to ACS,according to whether dapagliflozin was applied after PCI,the patients were divided into dapagliflozin group(n=33)and control group(n=56),The number of target vessels in the dapagliflozin group n=48,and the number in the control group n=92.All patients were readmitted for coronary angiography between 6 and 12 months postoperatively,to determine whether the target vessels have stent restenosis and the degree of stenosis.Serological indexes,the degree of vascular stenosis before percutaneous coronary intervention,the residual stenosis of the target lesion immediately after surgery,and the stent conditions of the target lesion after coronary angiography were compared between two groups.The patients were divided into stenosis group(n=30)and non-stenosis group(n=59)according to the reexamination of the target lesion stenosis,compared two groups of patients medical history,blood routine,liver function,renal function,blood routine and blood coagulation function related serological indexes,length and diameter of stent placement,medication after primary percutaneous coronary interention,and use the binary Logistic regression analysis to identify multiple factors in patients with type 2 diabetes of stent restenosis occurred after primary percutaneous coronary interention risk factors.Results:There were no significant differences in the general condition,serological indexes and the degree of target lesion stenosis before percutaneous coronary intervention between the dapagliflozin group and the control group(P>0.05),there was no significant difference in the residual stenosis of the target lesion,the length and diameter of the stent implantation between the two groups(P>0.05).After 6-12 months of medication,there were no statistically significant differences in fasting blood glucose,glycosylated hemoglobin,liver function,blood routine,coagulation function and other serological indexes between the dapagliflozin group and the control group(P>0.05),while there were statistically significant differences between groups in N terminal pro B type natriuretic peptide and left ventricular end-diastolic diameter,as well as estimated glomerular filtration rate(GFR)related to renal function(P<0.05),there was statistically significant difference between the groups in the stent condition of the target lesion analyzed by coronary angiography(P<0.01).There were no statistically significant differences between the restenosis group and the non-stenosis group in medical history,blood routine,liver function,renal function,blood routine,coagulation function and other serological indexes,length and diameter of stent implantation,anti-myocardial remodeling after percutaneous coronary intervention and other drug application(P<0.05),while the usage rate of dapagliflozin in the stenosis group was lower than that in the non-stenosis group,and the stent length was longer than that in the non-stenosis group(P<0.05).Multivariate Logistic regression analysis showed that intra-stent restenosis can be avoided to some extent by dapagliflozin(OR=0.198,95%CI 0.064-0.609),and stent length promoted the occurrence of in-stent restenosis(OR=1.026,95%CI 1.005-1.047).Conclusion:For patients with ACS combined with T2DM and receiving PCI,compared with other hypoglycemic drugs,dapagliflozin can bring a variety of cardiovascular benefits when it is released to the same hypoglycemic degree.The application of dapagliflozin has a protective effect on the occurrence of ISR,and the longer the stent is,the more likely ISR will occur.