■从2008年起和罗格列酮撤出后,对上市降血糖药物进行强制性心血管结局试验,以确保其心血管(CV)安全性.矛盾的是,这些研究证明了CV的安全性,但也显示了一些治疗药物的额外心血管保护作用.此外,非甾体盐皮质激素受体拮抗剂(ns-MRA)已成为2型糖尿病(T2D)和慢性肾病(CKD)的心脏和肾脏保护的新型药物.除了动脉粥样硬化性心血管疾病,心力衰竭(HF)和CKD是T2D的重要临床问题,导致生活质量差和过早死亡,因为这样的心血管保护是一个重要的临床问题。
■基于新的降糖药物和ns-MRA,我们为T2D中的药物治疗心肺血管保护提供了新的见解。搜索了PUBMED/CINAHL/WebofScience/Scopus(2024年5月)。
■仅实施了数十年的常规降糖方法现在已被使用降低CV事件发生率的疾病改善药物所取代。HF代偿失调,因HF住院,CKD进展缓慢和全因死亡率。的确,T2D的药物选择应关注潜在的合并症和心血管保护,而不是以葡萄糖为中心的方法.
UNASSIGNED: From 2008 and following the withdrawal of rosiglitazone, obligatory cardiovascular outcomes trials are performed for glucose lowering drugs introduced to the market to ensure their cardiovascular (CV) safety. Paradoxically, these studies have demonstrated CV safety but also shown additional cardio-reno-vascular protection of some therapeutic agents. Additionally, nonsteroidal mineralocorticoid receptor antagonists (ns-MRA) have emerged as novel drugs for cardio - and renoprotection in type 2 diabetes (T2D) and chronic kidney disease (CKD). In addition to atherosclerotic cardiovascular disease, heart failure (HF) and CKD are important clinical problems in T2D leading to poor quality of life and premature death as such cardio-reno-vascular protection is an important clinical issue.
UNASSIGNED: We provide new insights into pharmacotherapeutic cardio-reno-vascular protection in T2D based on the new glucose lowering drugs and ns-MRA. PUB MED/CINAHL/Web of Science/Scopus were searched (May 2024).
UNASSIGNED: The conventional glucose lowering approach alone which was implemented for decades is now replaced by the use of disease modifying drugs which lower the rates of CV events, HF decompensation, hospitalization due to HF, slow progression of CKD and all-cause mortality. Indeed, the choice of medications in T2D should be focused on underlying co-morbidities with cardio-reno-vascular protection rather than a gluco-centric approach.