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Objective: To study the clinical efficacy of Dapagliflozin in patients with coronary heart disease (CHD) combined with Heart Failure with Reduced Ejection Fraction (HFrEF) and type 2 diabetes mellitus (T2DM) who have CHD. Methods: A retrospective analysis of 202 patients with CHD and T2DM who were hospitalized in our department of cardiovascular medicine and underwent PCI treatment from November 2019 to November 2022 was conducted. Patients were divided into two groups according to whether they received Dapagliflozin treatment: the Dapagliflozin group (n=100) and the control group (n=102). A subgroup analysis was performed on the 80 HFrEF patients in the total population, which was also divided into two groups: the Dapagliflozin group (n=44) and the control group (n=36). The incidence of major adverse cardiovascular events (MACE) during hospitalization and the median follow-up period (224.5 days) was recorded and analyzed in both the total population and the subgroup. Results: The results of the analysis of the total patient population showed no statistical differences between the two groups in baseline data and related clinical treatment conditions (P>0.05). The follow-up period event analysis showed that the overall MACE event rate in the Dapagliflozin group was lower than that in the control group (6.00% vs. 17.65%), but not statistically significant (P=0.071). The COX regression analysis of MACE events showed that the use of Dapagliflozin was an independent protective factor for MACE events [HR=0.166, 95% CI (0.026-0.953), P=0.047]. In the HFrEF subgroup analysis, there was no significant difference between the two groups in the baseline data analysis (P>0.05). The COX regression analysis in the subgroup analysis showed that the use of Dapagliflozin was a strong protective factor for the HFrEF subgroup during the follow-up period [HR=0.250, 95% CI (0.017-0.518), P Conclusion: The use of Dapagliflozin in patients with CHD combined with HFrEF and T2DM may be effective in reducing the incidence of MACE.

Blood glucose levels are associated with the prognosis of patients with acute coronary syndrome (ACS). Glycated hemoglobin (HbA1c) reflects the average blood glucose level. The purpose of the study was to evaluate HbA1c as a prognostic indicator for ACS. In total, 27,337 ACS patients from the CCC-ACS (Improving Care for Cardiovascular Disease in China - Acute Coronary Syndrome) project were enrolled in this study and divided into three groups according to HbA1c level: Group I, HbA1c level

Risk stratification with specific biomarkers is proposed for tailored P2Y12 inhibitor therapy in patients with STEMI.This nationwide registry and quality improvement study is from November 1, 2014, to June 30, 2017. In total, 11,512 STEMI patients received aspirin and P2Y12 receptor inhibitor (clopidogrel or ticagrelor) and underwent PCIs in hospitals. Of the patients, 2992 were prescribed ticagrelor and 8520 clopidogrel. The primary effectiveness outcome was major adverse cardiovascular and cerebrovascular events (MACCE: cardiac death, myocardial infarction, stent thrombosis, in-hospital ischemic stroke). The primary safety outcome was in-hospital major bleeding.MACCE incidence was lower in the ticagrelor group than in the clopidogrel group (0.8% versus 1.2%; P=0.046), but under different NT-proBNP levels, cumulative hazards of MACCE were without statistical significance. Bleeding rates were higher in the ticagrelor group than in the clopidogrel group (all bleeding: 9.9% versus 6.9%, P0.001; major bleeding: 4.0% versus 2.7%, P0.001). The higher cumulative hazard of bleeding could be identified in the Kaplan-Meier curves. In the multivariate analysis, ticagrelor increased bleeding events, compared with clopidogrel, at NT-proBNP1800 ng/L patients (all bleeding: HR 1.46; 95%CI, 1.07-2.01; major bleeding: HR 1.68, 95%CI, 1.03-2.74), but a low effect was found in those with lower NT-proBNP level. Subgroup analyses show that ticagrelor increased major bleeding in patients with left ventricular ejection fraction (LVEF)0.50 (HR 3.29; 95% CI 1.61-6.74) (interaction p=0.03).We found that ticagrelor, compared with clopidogrel, increased bleeding complications in hospitalized patients with NT-proBNP1800 ng/L, especially in patients with EF 0.50.

Blood glucose levels are associated with the prognosis of patients with acute coronary syndrome (ACS). Glycated hemoglobin (HbA1c) reflects the average blood glucose level. The purpose of the study was to evaluate HbA1c as a prognostic indicator for ACS.In total, 27,337 ACS patients from the CCC-ACS (Improving Care for Cardiovascular Disease in China - Acute Coronary Syndrome) project were enrolled in this study and divided into three groups according to HbA1c level: Group I, HbA1c level5.7%; Group II, HbA1c level 5.7-6.4%; Group III, HbA1c level ≥6.5%. The primary outcome was an in-hospital major adverse cardiovascular event (MACE), such as all-cause death, recurrent myocardial infarction, acute or subacute stent thrombosis, heart failure, cardiogenic shock, or cardiac arrest. Baseline data and effectiveness outcome were compared among patients in the three groups.Group III had the highest MACE incidence (13.4% [Group III] vs. 8.7% [Group I] and 10.5% [Group II], p 0.001). In the logistic regression, there was a statistically significant difference in HbA1c level between the groups (odds ratio [OR]: 1.110, 95% confidence interval [CI]: 1.008-1.133, p 0.001). In the receiver operating characteristic curve, the area under the curve for MACE was 0.560 (95% CI: 0.550-0.571, p 0.001); the cut-off value for the HbA1c level was 6.38%.The HbA1c level was associated with the risk of MACEs in ACS patients with or without diabetes. Trial Registration clinicaltrials.gov, NCT02306616. Registered 3 December 2014-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02306616 .HINTERGRUND: Der Blutzuckerspiegel steht in einem Zusammenhang mit der Prognose von Patienten mit akutem Koronarsyndrom (ACS). Das glykierte Hämoglobin (HbA1c) ist ein Marker für den durchschnittlichen Blutzuckerspiegel. Ziel der vorliegenden Studie war es, HbA1c als prognostischen Indikator des ACS zu untersuchen.In die vorliegende Studie wurden 27.337 ACS-Patienten aus dem CCC-ACS-Projekt (Improving Care for Cardiovascular Disease in China – Acute Coronary Syndrome) einbezogen und nach ihrem HbA1c-Wert in 3 Gruppen eingeteilt: Gruppe I mit einem HbA1c-Wert5,7 %; Gruppe II mit einem HbA1c-Wert von 5,7–6,4 %; Gruppe III mit einem HbA1c-Wert ≥6,5 %. Primärer Endpunkt war ein schweres kardiovaskuläres unerwünschtes Ereignis im Krankenhaus (MACE), wie Tod aus sämtlichen Ursachen, Rezidiv eines Herzinfarkts, akute oder subakute Stentthrombose, Herzinsuffizienz, kardiogener Schock oder Herzstillstand. Die Ausgangsdaten und das Ergebnis hinsichtlich der Wirksamkeit wurden zwischen den Patienten in den 3 Gruppen verglichen.Die höchste MACE-Inzidenz bestand in Gruppe III (13,4 % [Gruppe III] vs. 8,7 % [Gruppe I] und 10,5 % [Gruppe II]; p 0,001). Im Rahmen der logistischen Regression gab es zwischen den Gruppen eine statistisch signifikante Differenz beim HbA1c-Wert (Odds Ratio, OR: 1,110; 95 %-Konfidenzintervall, 95 %-KI: 1,008–1,133; p 0,001). In der Receiver-Operating-Characteristic-Kurve betrug die Fläche unter der Kurve für MACE 0,560 (95 %-KI: 0,550–0,571; p 0,001); der Grenzwert für den HbA1c-Wert lag bei 6,38 %.Der HbA1c-Wert weist einen Zusammenhang mit dem Risiko für MACE bei ACS-Patienten mit oder ohne Diabetes mellitus auf. Studienregistrierung: clinicaltrials.gov, NCT02306616. Registrierung 3. Dezember 2014 – retrospektiv registriert, https://clinicaltrials.gov/ct2/show/NCT02306616 .