Effect Of Dagaglizin On Clinical Prognosis Of Patients With Acute Myocardial Infarction Complicated With Type 2 Diabetes After PCI

Objectives To investigate the effect of Dapagliflozin on the prognosis of patients with acute myocardial infarction and type 2 diabetes mellitus after percutaneous coronary intervention.Methods A total of 160 patients with type 2 diabetes who underwent coronary angiography and percutaneous coronary intervention for acute myocardial infarction in the Department of Cardiology,Tangshan GONGREN Hospital from September 2019 to March2021 were enrolled.They were divided into Dapagliflozin group and control group according to whether they had taken Dapagliflozin antiglycemic agents.Dapagliflozin group included 80 patients,and control group included 80 patients.Dapagliflozin group was added with Dapagliflozin 10 mg on the basis of the original hypoglycemic drugs,while the control group maintained the original drug treatment regimen and adjusted the dose according to the blood glucose level.Two groups of patients before treatment and 12 months after treatment,body mass index(BMI),waist circumference,systolic pressure,diastolic blood pressure,fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),serum total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDLC),low density lipoprotein cholesterol(LDL-C).The left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)of the two groups were recorded by color Doppler ultrasound in the department of Cardiology,Tangshan GONGREN Hospital,at admission and after 12 months of follow-up.Primary endpoints at 12 months of follow-up included cardiovascular death,myocardial reinfarction,and stroke,and secondary endpoints were stent restenosis and hospital readmission for angina pectoris and heart failure.All kinds of adverse reactions occurred during medication were recorded.SPSS 22.0 was used for statistical analysis.Results 1 After 12 months of medication,the increment of BMI,waist circumference,systolic blood pressure,diastolic blood pressure,FPG,HbA1 c,TG and HDL-C in dapagliflozin group was significantly higher than that in the control group,with statistical significance(P<0.05).2 After 12 months of medication,LVEDD level in both groups was lower than before,and dapagliflozin group was lower than control group,the difference was statistically significant(P<0.05),After treatment,the level of LVEF in 2 groups was higher than before,and dapagliflozin group was higher than control group,the difference was statistically significant(P<0.05).3 In terms of the main outcome,the incidence of cardiovascular death,myocardial reinfarction and stroke in dapagliflozin group was not significantly different from that in the control group,and the differences were not statistically significant(P>0.05).In terms of secondary outcomes,the incidence of in-stent restenosis,hospitalization due to angina pectoris,and hospitalization due to heart failure in the dapagliflozin group were lower than those in the control group,with statistical significance(P<0.05).4 After 12 months of medication,there was no significant difference in the incidence of urinary and reproductive system infection,non-traumatic amputation,hypoglycemia and ketoacidosis between the dapagliflozin group and the control group(P>0.05).Conclusions Dapagliflozin reduced the incidence of restenosis and the incidence of angina pectoris and heart failure readmission after stent implantation in patients with acute myocardial infarction and type 2 diabetes,but did not reduce the incidence of cardiovascular death,myocardial infarction and stroke,and significantly improved the clinical prognosis of myocardial infarction patients,and did not increase the incidence of adverse reactions.Figure0;Table5;Reference 139...