{"id":34652,"date":"2024-05-02T17:42:13","date_gmt":"2024-05-02T09:42:13","guid":{"rendered":"https:\/\/docquity.com\/?post_type=articles&p=34652"},"modified":"2025-02-11T13:40:07","modified_gmt":"2025-02-11T05:40:07","slug":"diem-tin-hoi-nghi-acc-2024-hieu-qua-cua-semaglutide-o-benh-nhan-suy-tim-phan-suat-tong-mau-bao-ton-mac-kem-beo-phi","status":"publish","type":"articles","link":"https:\/\/docquity.com\/vi\/articles\/diem-tin-hoi-nghi-acc-2024-hieu-qua-cua-semaglutide-o-benh-nhan-suy-tim-phan-suat-tong-mau-bao-ton-mac-kem-beo-phi\/","title":{"rendered":"\u0110i\u1ec3m tin H\u1ed9i ngh\u1ecb ACC 2024: Hi\u1ec7u qu\u1ea3 c\u1ee7a semaglutide \u1edf b\u1ec7nh nh\u00e2n suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u b\u1ea3o t\u1ed3n m\u1eafc k\u00e8m b\u00e9o ph\u00ec"},"content":{"rendered":"\n

V\u00e0o ng\u00e0y 07 th\u00e1ng T\u01b0 v\u1eeba qua, nghi\u00ean c\u1ee9u v\u1ec1 hi\u1ec7u qu\u1ea3 c\u1ee7a semaglutide \u1edf b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec li\u00ean quan \u0111\u1ebfn suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u b\u1ea3o t\u1ed3n \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o t\u1ea1i H\u1ed9i ngh\u1ecb Th\u01b0\u1eddng ni\u00ean c\u1ee7a Vi\u1ec7n Tim m\u1ea1ch Hoa K\u1ef3 (ACC) n\u0103m 2024.<\/p>\n\n\n\n

Trong c\u00e1c th\u1eed nghi\u1ec7m STEP \u2013 HFpEF v\u00e0 STEP \u2013 HFpEF DM, ch\u1ea5t ch\u1ee7 v\u1eadn th\u1ee5 th\u1ec3 GLP \u2013 1 \u0111\u00e3 cho th\u1ea5y kh\u1ea3 n\u0103ng c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng, h\u1ea1n ch\u1ebf v\u1ec1 th\u1ec3 ch\u1ea5t, c\u00e2n n\u1eb7ng v\u00e0 ch\u1ee9c n\u0103ng v\u1eadn \u0111\u1ed9ng \u1edf b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec li\u00ean quan \u0111\u1ebfn suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u b\u1ea3o t\u1ed3n. Nghi\u00ean c\u1ee9u n\u00e0y ti\u1ebfn h\u00e0nh ph\u00e2n t\u00edch d\u00e2n s\u1ed1 g\u1ed9p (pooled analysis) c\u1ee7a c\u1ea3 2 th\u1eed nghi\u1ec7m STEP \u2013 HFpEF v\u00e0 STEP \u2013 HFpEF DM \u0111\u1ec3 \u0111\u01b0a ra \u0111\u00e1nh gi\u00e1 cu\u1ed1i c\u00f9ng cho hi\u1ec7u qu\u1ea3 c\u1ee7a semaglutide [1]. B\u00e0i vi\u1ebft nh\u1eb1m t\u00f3m t\u1eaft k\u1ebft qu\u1ea3 c\u1ee7a ph\u00e2n t\u00edch n\u00e0y.<\/p>\n\n\n\n


H\u00ecnh 1.<\/strong> T\u00f3m t\u1eaft k\u1ebft qu\u1ea3 ph\u00e2n t\u00edch d\u00e2n s\u1ed1 g\u1ed9p<\/p>\n\n\n\n

Th\u1eed nghi\u1ec7m STEP \u2013 HFpEF v\u00e0 th\u1eed nghi\u1ec7m STEP \u2013 HFpEF DM<\/strong><\/h2>\n\n\n\n

Th\u1eed nghi\u1ec7m STEP \u2013 HFpEF \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh nh\u1eb1m \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 c\u1ee7a ch\u1ea5t ch\u1ee7 v\u1eadn th\u1ee5 th\u1ec3 GLP \u2013 1 semaglutide \u1edf b\u1ec7nh nh\u00e2n suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u b\u1ea3o t\u1ed3n v\u00e0 c\u00f3 BMI \u2265 30 kg\/m2<\/sup> <\/sub>m\u00e0 kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2. \u0110\u00e2y l\u00e0 th\u1eed nghi\u1ec7m \u0111\u1ea7u ti\u00ean \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 c\u1ee7a ch\u1ea5t ch\u1ee7 v\u1eadn th\u1ee5 th\u1ec3 GLP \u2013 1 \u1edf b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec li\u00ean quan \u0111\u1ebfn suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u b\u1ea3o t\u1ed3n. Nghi\u00ean c\u1ee9u STEP \u2013 HFpEF \u0111\u00e3 cho th\u1ea5y semaglutide h\u1ed7 tr\u1ee3 c\u1ea3i thi\u1ec7n c\u00f3 \u00fd ngh\u0129a tri\u1ec7u ch\u1ee9ng, h\u1ea1n ch\u1ebf th\u1ec3 ch\u1ea5t, ch\u1ee9c n\u0103ng v\u1eadn \u0111\u1ed9ng v\u00e0 c\u00e2n n\u1eb7ng so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c[2]<\/sup>.<\/p>\n\n\n\n

V\u1edbi m\u1ee5c \u0111\u00edch t\u01b0\u01a1ng t\u1ef1 th\u1eed nghi\u1ec7m STEP \u2013 HFpEF, th\u1eed nghi\u1ec7m STEP \u2013 HFpEF DM \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh tr\u00ean b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec li\u00ean quan \u0111\u1ebfn suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u b\u1ea3o t\u1ed3n v\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2. K\u1ebft qu\u1ea3 cho th\u1ea5y semaglutide c\u1ea3i thi\u1ec7n c\u00f3 \u00fd ngh\u0129a k\u1ebft c\u1ee5c suy tim so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c [3]<\/sup>.<\/p>\n\n\n\n

Ph\u00e2n t\u00edch d\u00e2n s\u1ed1 g\u1ed9p (pooled analysis)<\/strong><\/h2>\n\n\n\n

Nghi\u00ean c\u1ee9u ph\u00e2n t\u00edch d\u00e2n s\u1ed1 g\u1ed9p t\u1eeb 2 th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng STEP \u2013 HFpEF v\u00e0 STEP \u2013 HFpEF DM. C\u00e1c th\u1eed nghi\u1ec7m n\u00e0y \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh t\u1ea1i 129 \u0111i\u1ec3m nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng \u1edf 18 qu\u1ed1c gia. Trong c\u1ea3 2 th\u1eed nghi\u1ec7m, b\u1ec7nh nh\u00e2n tham gia nghi\u00ean c\u1ee9u \u0111\u1ec1u \u2265 18 tu\u1ed5i, m\u1eafc suy tim v\u1edbi ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u th\u1ea5t tr\u00e1i \u2265 45%, c\u00f3 BMI \u2265 30 kg\/m2<\/sup>, tri\u1ec7u ch\u1ee9ng suy tim II \u2013 IV theo ph\u00e2n \u0111\u1ed9 suy tim New York, \u0111i\u1ec3m s\u1ed1 Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCC1 \u2013 CSS, nh\u1eb1m \u0111o l\u01b0\u1eddng c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 h\u1ea1n ch\u1ebf th\u1ec3 ch\u1ea5t li\u00ean quan \u0111\u1ebfn suy tim) < 90 \u0111i\u1ec3m. Ng\u01b0\u1eddi tham gia nghi\u00ean c\u1ee9u t\u1eeb th\u1eed nghi\u1ec7m STEP \u2013 HFpEF kh\u00f4ng m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, trong khi ng\u01b0\u1eddi tham gia nghi\u00ean c\u1ee9u th\u1eed nghi\u1ec7m STEP \u2013 HFpEF DM \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Trong c\u1ea3 2 th\u1eed nghi\u1ec7m, nh\u1eefng ng\u01b0\u1eddi tham gia nghi\u00ean c\u1ee9u \u0111\u1ec1u \u0111\u01b0\u1ee3c ph\u00e2n ng\u1eabu nhi\u00ean th\u00e0nh 2 nh\u00f3m \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb v\u1edbi semaglutide li\u1ec1u 2.4 mg x 1 l\u1ea7n\/tu\u1ea7n ho\u1eb7c gi\u1ea3 d\u01b0\u1ee3c trong v\u00f2ng 52 tu\u1ea7n [1]<\/sup>.<\/p>\n\n\n\n

Ti\u00eau ch\u00ed \u0111\u00e1nh gi\u00e1 ch\u00ednh bao g\u1ed3m nh\u1eefng thay \u0111\u1ed5i c\u1ee7a c\u00e1c ch\u1ec9 s\u1ed1 KCCQ \u2013 CSS v\u00e0 c\u00e2n n\u1eb7ng sau 52 tu\u1ea7n theo d\u00f5i so v\u1edbi \u0111\u01b0\u1eddng n\u1ec1n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n tham gia nghi\u00ean c\u1ee9u STEP \u2013 HFpEF v\u00e0 STEP \u2013 HFpEF DM. Ti\u00eau ch\u00ed \u0111\u00e1nh gi\u00e1 ph\u1ee5 bao g\u1ed3m nh\u1eefng thay \u0111\u1ed5i \u0111\u1ed1i v\u1edbi \u0111\u00e1nh gi\u00e1 6 ph\u00fat \u0111i b\u1ed9, ti\u00eau ch\u00ed g\u1ed9p (t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n, bi\u1ebfn c\u1ed1 suy tim v\u00e0 nh\u1eefng thay \u0111\u1ed5i trong KCCQ-CSS v\u00e0 \u0111\u00e1nh g\u00eda 6 ph\u00fat \u0111i b\u1ed9) v\u00e0 n\u1ed3ng \u0111\u1ed9 C-reactive protein (CRP) sau 52 tu\u1ea7n theo d\u00f5i so v\u1edbi \u0111\u01b0\u1eddng n\u1ec1n [1]<\/sup>. N\u1ed3ng \u0111\u1ed9 CRP c\u0169ng gi\u1ea3m c\u00f3 \u00fd ngh\u0129a \u1edf nh\u00f3m \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi semaglutide so v\u1edbi nh\u00f3m gi\u1ea3 d\u01b0\u1ee3c [1]<\/sup>.<\/p>\n\n\n\n

K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u<\/strong><\/h2>\n\n\n\n

Ph\u00e2n t\u00edch bao g\u1ed3m t\u1ed5ng 529 b\u1ec7nh nh\u00e2n t\u1eeb th\u1eed nghi\u1ec7m STEP \u2013 HFpEF v\u00e0 616 b\u1ec7nh nh\u00e2n t\u1eeb th\u1eed nghi\u1ec7m STEP \u2013 HFpEF DM. T\u1ed5ng c\u1ed9ng c\u00f3 1145 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c bao g\u1ed3m trong ph\u00e2n t\u00edch d\u00e2n s\u1ed1 g\u1ed9p (v\u1edbi 573 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi semaglutide v\u00e0 572 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi gi\u1ea3 d\u01b0\u1ee3c).<\/p>\n\n\n\n

Sau 52 tu\u1ea7n theo d\u00f5i, nh\u1eefng c\u1ea3i thi\u1ec7n v\u1ec1 \u0111i\u1ec3m s\u1ed1 KCCQ-CSS v\u00e0 c\u00e2n n\u1eb7ng gi\u1ea3m cao h\u01a1n c\u00f3 \u00fd ngh\u0129a \u1edf nh\u00f3m b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi semaglutide 2.4 mg x 1 l\u1ea7n\/tu\u1ea7n [1]. C\u1ee5 th\u1ec3, s\u1ef1 kh\u00e1c bi\u1ec7t trung b\u00ecnh v\u1ec1 KCCQ-CSS gi\u1eefa 2 nh\u00f3m semaglutide v\u00e0 gi\u1ea3 d\u01b0\u1ee3c l\u00e0 7.5 \u0111i\u1ec3m v\u00e0 s\u1ef1 kh\u00e1c bi\u1ec7t trung b\u00ecnh v\u1ec1 c\u00e2n n\u1eb7ng gi\u1ea3m gi\u1eefa 2 nh\u00f3m semaglutide v\u00e0 gi\u1ea3 d\u01b0\u1ee3c l\u00e0 \u2013 8.4%.<\/p>\n\n\n\n

\u0110\u1ed1i v\u1edbi ti\u00eau ch\u00ed \u0111\u00e1nh gi\u00e1 ph\u1ee5, k\u1ebft qu\u1ea3 \u0111\u00e1nh gi\u00e1 6 ph\u00fat \u0111i b\u1ed9 v\u00e0 ti\u00eau ch\u00ed g\u1ed9p (t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n, bi\u1ebfn c\u1ed1 suy tim v\u00e0 nh\u1eefng thay \u0111\u1ed5i trong KCCQ-CSS v\u00e0 \u0111\u00e1nh g\u00eda 6 ph\u00fat \u0111i b\u1ed9) \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n c\u00f3 \u00fd ngh\u0129a \u1edf nh\u00f3m \u0111i\u1ec1u tr\u1ecb v\u1edbi semaglutide so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c. Hi\u1ec7u l\u1ef1c c\u1ee7a semaglutide lu\u00f4n t\u01b0\u01a1ng t\u1ef1 khi ph\u00e2n t\u00edch gi\u1eefa c\u00e1c nh\u00f3m ph\u1ee5, bao g\u1ed3m ph\u00e2n nh\u00f3m theo tu\u1ed5i t\u00e1c, ch\u1ee7ng t\u1ed9c, gi\u1edbi t\u00ednh, BMI, huy\u1ebft \u00e1p t\u00e2m thu, CRP n\u1ec1n v\u00e0 ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u th\u1ea5t tr\u00e1i.<\/p>\n\n\n\n

K\u1ebft lu\u1eadn<\/strong><\/h2>\n\n\n\n

Semaglutide v\u01b0\u1ee3t tr\u1ed9i h\u01a1n gi\u1ea3 d\u01b0\u1ee3c trong vi\u1ec7c c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng li\u00ean quan \u0111\u1ebfn suy tim, nh\u1eefng h\u1ea1n ch\u1ebf th\u1ec3 ch\u1ea5t v\u00e0 gi\u1ea3m c\u00e2n \u1edf b\u1ec7nh nh\u00e2n m\u1eafc \u0111\u1ed3ng th\u1eddi b\u00e9o ph\u00ec v\u00e0 suy tim. Tuy nhi\u00ean, c\u1ea7n l\u01b0u \u00fd r\u1eb1ng c\u1ea3 2 th\u1eed nghi\u1ec7m STEP \u2013 HFpEF v\u00e0 STEP \u2013 HFpEF DM \u0111\u1ec1u \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh tr\u01b0\u1edbc khi SGLT2i \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u b\u1ea3o t\u1ed3n. C\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean v\u1edbi quy m\u00f4 \u0111\u1ee7 l\u1edbn c\u1ea7n \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh trong t\u01b0\u01a1ng lai \u0111\u1ec3 th\u1ea9m \u0111\u1ecbnh hi\u1ec7u l\u1ef1c c\u1ee7a semaglutide \u0111\u1ed1i v\u1edbi c\u00e1c ti\u00eau ch\u00ed quan tr\u1ecdng c\u1ee7a suy tim ph\u00e2n su\u1ea5t t\u1ed1ng m\u00e1u b\u1ea3o t\u1ed3n.<\/p>\n\n\n\n

\n\n\n\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/h3>\n\n\n\n
    \n
  1. Butler J, Shah SJ, Petrie MC et al; STEP-HFpEF Trial Committees and Investigators. Semaglutide versus placebo in people with obesity-related heart failure with preserved ejection fraction: a pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials. Lancet. 2024 Apr 4:S0140-6736(24)00469-0. doi: 10.1016\/S0140-6736(24)00469-0.<\/li>\n\n\n\n
  2. Kosiborod MN, Abildstr\u00f8m SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med 2023; 389: 1069\u201384.<\/li>\n\n\n\n
  3. Kosiborod MN, Petrie MC, Borlaug BA, et al; STEP-HFpEF DM Trial Committees and Investigators. Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes. N Engl J Med. 2024 Apr 18;390(15):1394-1407. doi: 10.1056\/NEJMoa2313917.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Semaglutide h\u1ed7 tr\u1ee3 c\u1ea3i thi\u1ec7n c\u00f3 \u00fd ngh\u0129a c\u00e1c tri\u1ec7u ch\u1ee9ng li\u00ean quan \u0111\u1ebfn suy tim, h\u1ea1n ch\u1ebf th\u1ec3 ch\u1ea5t, ch\u1ee9c n\u0103ng v\u1eadn \u0111\u1ed9ng v\u00e0 c\u00e2n n\u1eb7ng \u1edf b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec m\u1eafc k\u00e8m suy tim so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c<\/p>\n","protected":false},"author":123,"featured_media":34718,"comment_status":"closed","ping_status":"closed","template":"","meta":{"content-type":"","inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"default","ast-global-header-display":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"articles_categories":[1370],"articles_tags":[],"articles_topics":[1439],"articles_languages":[1375],"articles_filters":[],"class_list":["post-34652","articles","type-articles","status-publish","has-post-thumbnail","hentry","articles_categories-medical-content-vi","articles_languages-vietnamese-vi"],"_links":{"self":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/34652","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles"}],"about":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/types\/articles"}],"author":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/users\/123"}],"replies":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/comments?post=34652"}],"version-history":[{"count":0,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/34652\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media\/34718"}],"wp:attachment":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media?parent=34652"}],"wp:term":[{"taxonomy":"articles_categories","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_categories?post=34652"},{"taxonomy":"articles_tags","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_tags?post=34652"},{"taxonomy":"articles_topics","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_topics?post=34652"},{"taxonomy":"articles_languages","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_languages?post=34652"},{"taxonomy":"articles_filters","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_filters?post=34652"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}