Dapagliflozin, Empagliflozin ve Eksenatid Kullanan Tip 2 Diyabetli Hastalarda Kardiyovasküler Olay Oranlarının Retrospektif Olarak Değerlendirilmesi

Abstract

Tip 2 diyabet hastalarında kardiyovasküler hastalıklar diyabeti olmayanlara göre daha yüksektir. SGLT-2 inhibitörlerinin (empagliflozin, dapagliflozin vb.) ve GLP-1 analoglarının (exenatid vb.) kardiyak etkilerine ilişkin olumlu sonuçlar veren geniş çaplı çalışmalar mevcuttur. Bu çalışmayla empagliflozin, dapagliflozin veya eksenatid kullanan hastalarda kardiyovasküler sonuçları değerlendirmek ve karşılaştırmak amaçlanmıştır. Kontrol grubu olarak kardiyak açıdan nötr olduğu bilinen DPP-4 inhibitörü (linagliptin) kullanan hastalar seçilmiştir. Bu çalışma her tedavi grubundan (linagliptin, eksenatid, dapagliflozin, empagliflozin) en az on iki aydır tedavi gören 100 hasta olmak üzere toplam 400 hasta ile gerçekleştirilmiştir. Miyokard enfarktüsü (MI), serebrovasküler olay (SVO), kardiyak nedenlere bağlı ölüm, majör kardiyovasküler olay (MACE: MI, SVO ve kardiyak ölüm), kalp yetmezliği nedeniyle hastaneye yatış, kararsız angina/akut koroner sendrom (AKS), periferik arter hastalığı ve tüm nedenlere bağlı ölümler değerlendirilmiştir. Tüm kardiyovasküler patolojilerin toplam oranları incelendiğinde linagliptin grubunda %10, eksenatid grubunda %6, dapagliflozin grubunda %4 ve empagliflozin grubunda %6 olarak tespit edilmiştir. Kardiyak hastalık öyküsü olmayan hastalar karşılaştırıldığında eksenatid, dapagliflozin ve empagliflozin grubunda toplam kardiyovasküler patoloji oranlarının linagliptin grubuna göre istatistiksel olarak anlamlı derecede azaldığı saptanmıştır. Kardiyak öyküsü olan hastalarda ise dapagliflozin ve empagliflozin grubunda angina/AKS tablosunun anlamlı derecede azaldığı ortaya konmuştur. Bu sonuçlar diyabet hastalarının kardiyak patolojilerden birincil korunmasında eksenatid, dapagliflozin ve empagliflozin moleküllerinin faydalı olduğunu göstermektedir. Dapagliflozin ve empagliflozin molekülleirinin hastaların kardiyovasküler patolojilerden sekonder korunmasında da tekili olabileceğini düşündürmektedir.

Keywords

• : Linagliptin
• Eksenatid
• Dapagliflozin
• Empagliflozin
• SGLT-2 inhibitörleri
• Kardiyovasküler Olay

Retrospective Evaluation of The Rate of Cardiovascular Events in Type 2 Diabetic Patients Using Dapagliflozin, Empagliflozin and Exenatide

Abstract

Cardiovascular diseases are more common in patients with type 2 diabetes than in those without diabetes. Large-scale studies have shown positive results regarding the cardiac effects of SGLT-2 inhibitors (empagliflozin, dapagliflozin, etc.) and GLP-1 analogs (exenatide, etc.). This study aimed to evaluate and compare cardiovascular outcomes in patients using empagliflozin, dapagliflozin, or exenatide. Patients using a DPP-4 inhibitor (linagliptin), known as cardiac neutral, were selected as the control group. This study was conducted with 400 patients, 100 of whom received treatment for at least twelve months from each treatment group (linagliptin, exenatide, dapagliflozin, and empagliflozin). Myocardial infarction (MI), cerebrovascular accident (CVA), death due to cardiac causes, major cardiovascular event (MACE: MI, CVA, and cardiac death), hospitalization due to heart failure, unstable angina/acute coronary syndrome (ACS), peripheral artery disease and all-cause deaths were evaluated. When the total rates of all cardiovascular pathologies were examined, it was determined that they were 10% in the linagliptin group, 6% in the exenatide group, 4% in the dapagliflozin group and 6% in the empagliflozin group. When patients without a history of cardiac disease were compared, it was determined that the total cardiovascular pathology rates in the exenatide, dapagliflozin, and empagliflozin groups were statistically significantly reduced compared to the linagliptin group. In patients with a cardiac history, it was revealed that angina/ACS was significantly reduced in the dapagliflozin and empagliflozin groups. These results show that exenatide, dapagliflozin, and empagliflozin molecules are helpful in the primary prevention of cardiac pathologies in our diabetic patients. Dapagliflozin and empagliflozin molecules may also be unique in the secondary protection of patients from cardiovascular pathologies.

Keywords

• Linagliptin
• Exenatide
• Dapagliflozin
• Empagliflozin
• SGLT-2 inhibitors
• Cardiovascular event

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