Abstract:
Over the last few years, given the increase in the incidence and prevalence of both type 2 diabetes mellitus (T2DM) and heart failure (HF), it became crucial to develop guidelines for the optimal preventive and treatment strategies for individuals facing these coexisting conditions. In patients aged over 65, HF hospitalization stands out as the predominant reason for hospital admissions, with their prognosis being associated with the presence or absence of T2DM. Historically, certain classes of glucose-lowering drugs, such as thiazolidinediones (rosiglitazone), raised concerns due to an observed increased risk of myocardial infarction (MI) and cardiovascular (CV)-related mortality. In response to these concerns, regulatory agencies started requiring CV outcome trials for all novel antidiabetic agents [i.e., dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and sodium-glucose cotransporter-2 inhibitors (SGLT2is)] with the aim to assess the CV safety of these drugs beyond glycemic control. This narrative review aims to address the current knowledge about the impact of glucose-lowering agents used in T2DM on HF prevention, prognosis, and outcome.
摘要:
在过去的几年里,鉴于2型糖尿病(T2DM)和心力衰竭(HF)的发病率和患病率增加,为面临这些共存疾病的个体制定最佳预防和治疗策略的指南变得至关重要.在65岁以上的患者中,HF住院是住院的主要原因,他们的预后与是否存在T2DM有关。历史上,某些种类的降糖药物,如噻唑烷二酮类(罗格列酮),由于观察到心肌梗死(MI)和心血管疾病(CV)相关死亡率的风险增加,引起了人们的关注.针对这些担忧,监管机构开始要求对所有新型抗糖尿病药进行CV结果试验[即,二肽基肽酶-4抑制剂(DPP-4抑制剂),胰高血糖素样肽-1受体激动剂(GLP-1RAs),和钠-葡萄糖协同转运蛋白-2抑制剂(SGLT2is)],旨在评估这些药物在血糖控制之外的CV安全性。这篇叙述性综述旨在探讨目前关于T2DM中使用的降糖药对HF预防的影响的知识。预后,和结果。