Objective. To explore the effect of dapagliflozin on cardiac function, inflammation, and cardiovascular outcome in patients with ST-segment elevation myocardial infarction (STEMI) combined with type 2 diabetes (T2DM) after percutaneous coronary intervention (PCI). Methods. 70 patients with STEMI and T2DM were divided into the control group (n = 35) and the observation group (n = 35). Before surgery, patients in both groups were given conventional treatments such as coronary expansion, antiplatelet, anticoagulation, and thrombolysis, and PCI was performed. After the operation, both groups were given conventional antiplatelet, anticoagulation, lipid-lowering, and hypoglycemic treatments. On this basis, the observation group was treated with dapagliflozin tablets for 24 weeks. We observe and compare the left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF), myocardial enzyme spectrum, inflammatory reaction, and occurrence of adverse cardiovascular events (MACE) of the two groups of patients before and after treatment. Results. After treatment, the LVEDD and LVESD of the two groups were lower than those before treatment, and the observation group was lower than the control group (P < 0.05). The LVEF of both groups was higher than that before treatment, and the observation group was higher than the control group (P < 0.05). After treatment, the levels of two groups’ patients’ creatine kinase (CK), creatine kinase isoenzyme (CK-MB), and troponin I (cTnI) were all lower than those before treatment, and the observation group patients were all lower than the control group (P < 0.05). After treatment, the levels of serum myeloperoxidase (MPO), C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α) in the two groups were all lower than those before treatment, and the observation group patients were all lower than the control group (P < 0.05). After treatment, there was no statistical difference between the two groups of patients in cardiogenic death, recurrent myocardial infarction, and other adverse cardiovascular events (P > 0.05). But, the incidence of severe arrhythmia and heart failure in the observation group were both lower than those in the control group (P < 0.05). Kaplan–Meier survival curve analysis showed that the median survival time without MACE in the observation group was higher than that in the control group (P < 0.05). Conclusion. Dapagliflozin treatment for patients with STEMI combined with T2DM after PCI can improve cardiac function to certain extent, reduce inflammation, and will reduce the incidence of adverse cardiovascular outcomes.
Background and Objective. Percutaneous coronary intervention (PCI) is expansively used in the treatment of chronic total occlusion (CTO), but there is a lack of effective means to predict the prognosis of CTO patients undergoing PCI. The aim of this study was to construct a risk model that could effectively predict disease progression after PCI treatment in patients with CTO and enrich the means of clinical prediction of prognosis. Methods. The clinical data of 82 patients with CTO who underwent PCI in Lianshui County People’s Hospital were collected in this study. The patients were divided into training set ( n = 54 ) and validation set ( n = 28 ) by random sampling method. Statistical difference test was performed for clinical features of patients. Univariate and multivariate Cox regression analyses were performed to determine the risk factors affecting progression of CTO. Nomogram was used to construct a prediction model for disease progression. C -index was calculated, and the accuracy of the model was tested by calibration curve. Results. No statistically significant differences were incorporated in baseline characteristics of included patients ( p > 0.05 ). There were 25 patients with adverse cardiac events during follow-up in the training set and 13 in the validation set. The results of multivariate Cox regression analysis demonstrated that the important factors affecting postoperative disease progression mainly came down to age, BMI, diabetes, creatinine clearance rate, and left ventricular fraction < 40 % . A nomogram was constructed and C -index was calculated. The calibration curve was then used to evaluate and predict risk model of disease progression. The result showed an internal validation C -index of 0.6219 and an external validation C -index of 0.6453, which indicated the good prediction performance of the model. Conclusion. The risk of disease progression in CTO patients treated with PCI can be effectively predicted by the risk model constructed in this study, which opens up a great possibility for enriching the means of predicting the prognosis of these patients in clinical practice.
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