Impact of SGLT2i on cardiovascular outcomes and heart failure in patients with type 2 diabetes

AIMS Medical Science

article

Juan José Rodríguez¹  Luis Ortega-Paz¹  Salvatore Brugaletta¹  Manel Sabaté¹ 

[1] Department of cardiology, hospital clinic, Biomedical Investigation Institute

关键词: sodium-glucose cotransporter 2 inhibitors;    dapagliflozin;    canagliflozin;    empagliflozin;    diabetes mellitus;    cardiovascular outcome trials;    heart failure;    ;   

DOI  :  10.3934/medsci.2018.1.67

来源: American Institute of Mathematical Sciences

【 摘 要 】

The concurrent management of type 2 diabetes mellitus and heart failure presents several challenges and unmet clinical needs. The sodium-glucose cotransporter 2 inhibitors (SGLT2i) are new generation of oral hypoglycemic agents, they inhibit renal glucose reabsorption and increase renal glucose excretion, thus lowering plasma glucose levels and contributing to a modest reduction in HbA1C. In two pivotal randomized clinical trial, SGLT2i have showed a clinically important reduction in cardiovascular mortality and hospitalization due to heart failure. However, also important adverse effects such as increased risk of bone fractures and lower limb amputations were found. Currently, physiological mechanisms leading to cardiovascular benefits with SGLT2i are not completely understood, but it seems accepted that some of these benefits are related to non-glycemic effects. In this review, we analyze the available clinical evidence focusing in cardiovascular outcomes and heart failure, physiological mechanism of action, and comment on future directions of research.

【 授权许可】

CC BY