Coronary Plaques in Acute Coronary Syndrome With

被引：10

作者：

Kurozumi, Atsumasa ^{[1
]}

Shishido, Koki ^{[1
]}

Yamashita, Takayoshi ^{[1
]}

Sato, Daisuke ^{[1
]}

Uchida, Syuhei ^{[1
]}

Koyama, Eiji ^{[1
]}

Tamaki, Yusuke ^{[1
]}

Hayashi, Takahiro ^{[1
]}

Miyashita, Hirokazu ^{[1
]}

Yokoyama, Hiroaki ^{[1
]}

Ochiai, Tomoki ^{[1
]}

Yamaguchi, Masashi ^{[1
]}

Moriyama, Noriaki ^{[1
]}

Tobita, Kazuki ^{[1
]}

Matsumoto, Takashi ^{[1
]}

Mizuno, Shingo ^{[1
]}

Yamanaka, Futoshi ^{[1
]}

Tanaka, Yutaka ^{[1
]}

Murakami, Masato ^{[1
]}

Takahashi, Saeko ^{[1
]}

Saito, Shigeru ^{[1
]}

机构：

[1] Shonan Kamakura Gen Hosp, Dept Cardiol, Kamakura, Japan

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2024年 / 214卷

关键词：

ACS; OCT; SGLT2i; unstable plaque; COTRANSPORTER; 2; INHIBITORS; CARDIOVASCULAR OUTCOMES; HEART-FAILURE; EMPAGLIFLOZIN; ASSOCIATION; MORTALITY;

D O I：

10.1016/j.amjcard.2023.12.056

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are widely used in cardiology and are effective in treating acute coronary syndrome (ACS). Their effects on unstable plaque in patients with ACS remains unclear. This study aimed to examine the effectiveness of SGLT2is in coronary plaque based on optical coherence tomography (OCT) images and the prognosis of ACS with type 2 diabetes mellitus. This retrospective study included 109 patients in the total cohort and 29 patients in the OCT cohort. Based on SGLT2i administration after ACS, the total cohort was categorized into non-SGLT2i (n = 69) and SGLT2i (n = 40) groups. The OCT cohort had 15 and 14 patients in the non-SGLT2i and SGLT2i groups, respectively. The OCT images of unstable plaque were analyzed in nonstented lesions during ACS catheterization and at the 6-month follow-up. The total cohort was assessed after 1 year for major adverse cardiovascular events, including all-cause mortality, revascularization, cerebrovascular disease, and heart failure hospitalization. SGLT2is improved unstable lesions with a significantly thicker fibrous cap (48 +/- 15 mm vs 26 +/- 24 mm, p = 0.005), reduced lipid arc (-29 +/- 12 degrees vs -18 +/- 14 degrees, p = 0.028), higher % decrease in total lipid arc (-35 +/- 13% vs -19 +/- 18%, p = 0.01), and lower major adverse cardiovascular event incidence (log-rank p = 0.023, hazard ratio 4.72 [1.08 to 20.63]) and revascularization rate (adjusted hazard ratio 6.77 [1.08 to 42.52]) than the non-SGLT2i group. In conclusion, SGLT2is can improve the markers of plaque stability and may improve the prognosis in patients with type 2 diabetes mellitus. (c) 2024 Elsevier Inc. All rights reserved. (Am J Cardiol 2024;214:47-54)

引用

页码：47 / 54

页数：8

共 38 条

[1] 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021 [J].

不详 .

DIABETES CARE, 2021, 44 :S15-S33

[2] Empagliflozin in Heart Failure with a Preserved Ejection Fraction [J].

Anker, Stefan D. ;

Butler, Javed ;

Filippatos, Gerasimos ;

Ferreira, Joao P. ;

Bocchi, Edimar ;

Boehm, Michael ;

Brunner-La Rocca, Hans-Peter ;

Choi, Dong-Ju ;

Chopra, Vijay ;

Chuquiure-Valenzuela, Eduardo ;

Giannetti, Nadia ;

Gomez-Mesa, Juan Esteban ;

Janssens, Stefan ;

Januzzi, James L. ;

Gonzalez-Juanatey, Jose R. ;

Merkely, Bela ;

Nicholls, Stephen J. ;

Perrone, Sergio V. ;

Pina, Ileana L. ;

Ponikowski, Piotr ;

Senni, Michele ;

Sim, David ;

Spinar, Jindrich ;

Squire, Iain ;

Taddei, Stefano ;

Tsutsui, Hiroyuki ;

Verma, Subodh ;

Vinereanu, Dragos ;

Zhang, Jian ;

Carson, Peter ;

Lam, Carolyn Su Ping ;

Marx, Nikolaus ;

Zeller, Cordula ;

Sattar, Naveed ;

Jamal, Waheed ;

Schnaidt, Sven ;

Schnee, Janet M. ;

Brueckmann, Martina ;

Pocock, Stuart J. ;

Zannad, Faiez ;

Packer, Milton .

NEW ENGLAND JOURNAL OF MEDICINE, 2021, 385 (16) :1451-1461

[3] Heart failure drug treatment: the fantastic four [J].

Bauersachs, Johann .

EUROPEAN HEART JOURNAL, 2021, 42 (06) :681-683

[4] Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitor Dapagliflozin Stabilizes Diabetes-Induced Atherosclerotic Plaque Instability [J].

Chen, Yung-Chih ;

Jandeleit-Dahm, Karin ;

Peter, Karlheinz .

JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2022, 11 (01)

[5]

[Anonymous], 2020, Eur Heart J, V41, P4317, DOI [10.1093/eurheartj/ehz486, 10.1093/eurheartj/ehz828]

[6] SGLT2 inhibitors: mechanisms of cardiovascular benefit beyond glycaemic control [J].

Cowie, Martin R. ;

Fisher, Miles .

NATURE REVIEWS CARDIOLOGY, 2020, 17 (12) :761-772

[7] Sodium-glucose co-transporter2 expression and inflammatory activity in diabetic atherosclerotic plaques: Effects of sodium-glucose co-transporter2 inhibitor treatment [J].

D'Onofrio, Nunzia ;

Sardu, Celestino ;

Trotta, Maria Consiglia ;

Scisciola, Lucia ;

Turriziani, Fabrizio ;

Ferraraccio, Franca ;

Panarese, Iacopo ;

Petrella, Lella ;

Fanelli, Mara ;

Modugno, Piero ;

Massetti, Massimo ;

Marfella, Ludovica Vittoria ;

Sasso, Ferdinando Carlo ;

Rizzo, Maria Rosaria ;

Barbieri, Michelangela ;

Furbatto, Fulvio ;

Minicucci, Fabio ;

Mauro, Ciro ;

Federici, Massimo ;

Balestrieri, Maria Luisa ;

Paolisso, Giuseppe ;

Marfella, Raffaele .

MOLECULAR METABOLISM, 2021, 54

[8] Cardiovascular protection by SGLT2 inhibitors-Do anti-inflammatory mechanisms play a role? [J].

Elrakaybi, Asmaa ;

Laubner, Katharina ;

Zhou, Qian ;

Hug, Martin J. ;

Seufert, Jochen .

MOLECULAR METABOLISM, 2022, 64

[9]

Gallwitz Baptist, 2018, Eur Endocrinol, V14, P17, DOI 10.17925/EE.2018.14.1.17

[10] Coronary Revascularization of Patients With Diabetes Mellitus in the Setting of Acute Coronary Syndromes [J].

Godoy, Lucas C. ;

Rao, Vivek ;

Farkouh, Michael E. .

CIRCULATION, 2019, 140 (15) :1233-1235

← 1 2 3 4 →