Öz
Amaç
Dapagliflozin ve empagliflozin gibi sodyum-glukoz ko-taşıyıcı-2 inhibitörlerinin kardiyoprotektif etkileri bilinmekle birlikte, akut koroner sendrom (AKS) sonrası erken sol ventrikül fonksiyonuna etkileri net değildir. Bu çalışma, tip 2 diyabetes mellituslu (T2DM) hastalarda dapagliflozin ve empagliflozinin AKS sonrası erken dönemde sol ventrikül ejeksiyon fraksiyonu (LVEF) üzerindeki etkilerini karşılaştırmayı ve azalmış LVEF için yordayıcı faktörleri saptamayı amaçlamıştır.
Yöntem ve Gereçler
Bu retrospektif çalışmaya, dapagliflozin (n=133) veya empagliflozin (n=221) tedavisi almakta iken AKS nedeniyle hastaneye yatırılan toplam 354 T2DM hastası dahil edilmiştir. Demografik, klinik ve ekokardiyografik veriler değerlendirildi. LVEF; korunmuş (≥%50), hafif azalmış (%41-49) ve azalmış (≤%40) olarak sınıflandırıldı. Azalmış LVEF ile ilişkili bağımsız faktörleri belirlemek için çok değişkenli lojistik regresyon analizi kullanıldı.
Bulgular
AKS sonrası LVEF değerleri dapagliflozin ve empagliflozin grupları arasında benzerdi (p=0,809). Bununla birlikte STEMI (p<0,001) ve göçmen olma durumu (p=0,023) azalmış LVEF (≤%40) ile bağımsız olarak ilişkili bulundu. LVEF <%50 olan tüm hastalar arasında ise yalnızca STEMI bağımsız bir yordayıcı olarak kaldı (p<0,001).
Sonuç
Dapagliflozin ve empagliflozin kullanan hastaların AKS sonrası erken dönemdeki LVEF değerleri benzer olsa da, T2DM hastalarında göçmen kökenli olmanın ve STEMI geçirmiş olmanın LVEF’de belirgin düşüş için risk faktörleri olduğu görülmektedir.
Anahtar Kelimeler:
Dapagliflozin, empagliflozin, tip 2 diyabetes mellitus, akut koroner sendrom, sol ventrikül ejeksiyon fraksiyonu
Kaynaklar
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