OBJECTIVE: Acute coronary syndrome (ACS) is a common cardiovascular complication in patients with type 2 diabetes mellitus (T2DM) and significantly increases the risk of disability and death in T2DM patients. Dapagliflozin inhibits blood glucose reabsorption, improves insulin resistance, and reduces the occurrence of long-term adverse cardiovascular events, indicating the importance of Dapagliflozin as a drug for type 2 diabetes patients and its close relationship with coronary atherosclerotic heart disease. At present, there are few studies on the effects of Dapagliflozin intervention on ventricular remodeling and myocardial microperfusion in patients with ACS combined with T2DM after PCI.
METHODS: Between January 2019 and August 2023, a total of 35 patients diagnosed with Coronary atherosclerotic heart disease and T2DM were chosen as the observation group using a multi-stage cluster sampling method. Concurrently, 35 patients with similar age, height, weight, and healthy physical examination results were selected as the control group during the same time frame. We collected demographic data, symptoms and underlying diseases of the two groups Before enrollment and 6 months after discharge and compared the data between the two groups. Subsequently, multivariate logistic regression analysis was employed to identify indicators with statistically significant differences and to summarize the potential risk factors that could impact ventricular remodeling in patients with Coronary atherosclerotic heart disease and T2DM.
RESULTS: There was significant difference in LDL-C between the two groups, and the difference was statistically significant (P < .05). After treatment, the levels of hs-CRP, FBG, HbAlc and IL-6 in both groups were significantly decreased, and the decrease was more obvious in the observation group, with statistical significance (P < .05). These results indicated that Dapagliflozin intervention could significantly inhibit postoperative inflammation in patients with ACS combined with T2DM after PCI. LVMI of Observation group patients was significantly higher than Comparison group, LVEDD and ESVI of Observation group patients were significantly lower than Comparison group. The difference was statistically significant (P < .05). These results indicated that Dapagliflozin intervention could significantly inhibit the improvement of blood glucose index, ventricular remodeling and myocardial microperfusion in patients with ACS combined with T2DM after PCI. After treatment, TIMI Flow Count Frame Count (CTFC) level and Myocardial Perfusion (TMPG) level in the observation group were significantly lower than those in the comparison group, and the difference was statistically significant (P < .05). These results indicated that Dapagliflozin intervention could significantly inhibit ventricular remodeling and improve myocardial microperfusion in patients with ACS combined with T2DM after PCI.
CONCLUSION: Dapagliflozin intervention can significantly inhibit inflammatory indexes in patients with Coronary atherosclerotic heart disease combined with T2DM after PCI, promote the improvement of blood glucose indexes, ventricular remodeling and myocardial microperfusion, and reduce the risk of occurrence.