Association between long-term prescription of metformin and the progression of heart failure with preserved ejection fraction in patients with type 2 diabetes mellitus and hypertension
Association between long-term prescription of metformin and the progression of heart failure with preserved ejection fraction in patients with type 2 diabetes mellitus and hypertension
复制标题
长期服用二甲双胍与 2 型糖尿病合并高血压患者射血分数保留的心力衰竭进展之间的关系
DOI：
10.1016/j.ijcard.2019.11.087
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发表时间：
2020-05-01
影响因子：
3.5
通讯作者：
Wang, Chang-qian
中科院分区：
文献类型：
--
作者：
Gu, Jun;Yin, Zhao-fang;Wang, Chang-qian
背景资料：2型糖尿病（T2 DM）和高血压与射血分数保留性心力衰竭（HFpEF）的后续事件风险增加独立相关。本研究旨在评估长期二甲双胍处方对这些患者的影响。方法：使用1：2比例的倾向评分匹配，本回顾性索赔数据库研究比较了二甲双胍处方（n = 130）和非二甲双胍治疗（n = 260）在T2 DM和高血压且无心力衰竭临床体征或症状的患者中的作用。结果：随访6年，二甲双胍组130例患者中有6例发生新发症状性HFpEF，非二甲双胍组260例患者中有31例发生新发症状性HFpEF（P = 0.020）。二甲双胍还可显著改善左心室（LV）舒张功能和肥大。考克斯比例风险回归模型显示二甲双胍处方（HR 0.351，95% CI：0.145-0.846，P = 0.020）与新发症状性HFpEF的风险降低相关。长期二甲双胍暴露与新发症状性HFpEF发生率方面的保护作用相关，2型糖尿病合并高血压患者的左室舒张功能不全和肥厚，这可能有利于延缓HFpEF的进展。(c)2019由Elsevier B. V.出版
Background: Type 2 diabetes mellitus (T2DM) and hypertension are independently related to increasing risk of subsequent incident heart failure with preserved ejection fraction (HFpEF). This study was designed to evaluate the influences of long-term metformin prescription in these patients.Methods: Using a propensity score matching of 1:2 ratio, this retrospective claims database study compared metformin prescription (n = 130) and non-metformin therapy (n = 260) in patients with T2DMand hypertension and without clinical signs or symptoms of heart failure.Results: With a follow-up of 6 years, the new-onset symptomatic HFpEF occurred in 6 of 130 patients in metformin group and 31 of 260 patients in non-metformin group (P = .020). Metformin also generated more prominent improvement in left ventricular (LV) diastolic function and hypertrophy. And Cox proportional hazards regression model revealed that metformin prescription (HR 0.351, 95% CI: 0.145-0.846, P = .020) was associated with a reduced risk of new onset of symptomatic HFpEF.Conclusions: Long-term metformin exposure was associated with protective effects in terms of the incidence of new-onset symptomatic HFpEF, LV diastolic dysfunction and hypertrophy in patients with T2DM and hypertension, which might be beneficial for the delay of HFpEF progression. (c) 2019 Published by Elsevier B.V.