Saraiva Francisco Kerr, Sposito Andrei C
Faculdade de Medicina, Pontifica Universidade Catolica de Campinas, Campinas, Brazil.
Laboratory of Atherosclerosis and Vascular Biology (AteroLab), Cardiology Division, State University of Campinas Medicine School (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil.
Cardiovasc Diabetol. 2014 Oct 22;13:142. doi: 10.1186/s12933-014-0142-7.
Patients with type 2 diabetes have a several-fold increased risk of developing cardiovascular disease when compared with nondiabetic controls. Myocardial infarction and stroke are responsible for 75% of all death in patients with diabetes, who present a 2-4× increased incidence of death from coronary artery disease. Patients with diabetes are considered for cardiovascular disease secondary prevention because their risk level is similar to that reported in patients without diabetes who have already suffered a myocardial infarction. More recently, with a better risk factors control, mainly in intensive LDL cholesterol targets with statins, a significant decrease in acute cardiovascular events was observed in population with diabetes. Together with other major risk factors, type 2 diabetes must be considered as an important cause of cardiovascular disease.Glucagon like peptide-1 receptor agonists represent a novel class of anti-hyperglycemic agents that have a cardiac-friendly profile, preserve neuronal cells and inhibit neuronal degeneration, an anti-inflammatory effect in liver protecting it against steatosis, increase insulin sensitivity, promote weight loss, and increase satiety or anorexia.This review is intended to rationally compile the multifactorial cardiovascular effects of glucagon-like peptide-1 receptor agonists available for the treatment of patients with type 2 diabetes.
与非糖尿病对照组相比，2型糖尿病患者发生心血管疾病的风险增加数倍。心肌梗死和中风导致糖尿病患者75%的死亡，糖尿病患者冠状动脉疾病的死亡率增加2至4倍。糖尿病患者被视为心血管疾病二级预防对象，因为他们的风险水平与已发生心肌梗死的非糖尿病患者相似。最近，通过更好地控制危险因素，主要是使用他汀类药物强化低密度脂蛋白胆固醇目标，糖尿病患者群体中急性心血管事件显著减少。与其他主要危险因素一起，2型糖尿病必须被视为心血管疾病的重要病因。胰高血糖素样肽-1受体激动剂是一类新型的抗高血糖药物，具有心脏友好特性，能保护神经元细胞并抑制神经元变性，在肝脏中有抗炎作用以防止脂肪变性，增加胰岛素敏感性，促进体重减轻，并增加饱腹感或食欲。本综述旨在合理汇总可用于治疗2型糖尿病患者的胰高血糖素样肽-1受体激动剂的多因素心血管效应。
