二肽基肽酶4抑制剂与心血管结局：对心力衰竭的安全性
DPP4 inhibitors and cardiovascular outcomes: safety on heart failure.
作者信息
Xia Chang, Goud Aditya, D'Souza Jason, Dahagam CHanukya, Rao Xiaoquan, Rajagopalan Sanjay, Zhong Jixin
机构信息
College of Health Science & Nursing, Wuhan Polytechnic University, Wuhan, Hubei, China.
Cardiovascular Research Institute, Case Western Reserve University, 2103 Cornell Road, Wolstein Research Building RM 4525, Cleveland, OH, 44106, USA.
出版信息
Heart Fail Rev. 2017 May;22(3):299-304. doi: 10.1007/s10741-017-9617-4.
Diabetes is an important risk factor for cardiovascular disease. However, clinical data suggests intensive glycemic control significantly increase rather than decrease cardiovascular mortality, which is largely due to the fact that a majority of oral anti-diabetic drugs have adverse cardiovascular effect. There are several large-scale clinical trials evaluating the cardiovascular safety of DPP4 inhibitors, a novel class of oral anti-diabetic medications, which have been recently completed. They were proven to be safe with regard to cardiovascular outcomes. However, concerns on the safety of heart failure have been raised as the SAVOR-TIMI 53 trial reported a 27% increase in the risk for heart failure hospitalization in diabetic patients treated with DPP4 inhibitor saxagliptin. In this review, we will discuss recent advances in the heart failure effects of DPP4 inhibition and GLP-1 agonism.
糖尿病是心血管疾病的重要危险因素。然而，临床数据表明，强化血糖控制显著增加而非降低心血管死亡率，这主要是因为大多数口服抗糖尿病药物具有不良心血管效应。有几项评估新型口服抗糖尿病药物二肽基肽酶4（DPP4）抑制剂心血管安全性的大规模临床试验最近已经完成。结果证明它们在心血管结局方面是安全的。然而，由于SAVOR-TIMI 53试验报告称，使用DPP4抑制剂沙格列汀治疗的糖尿病患者心力衰竭住院风险增加了27%，因此人们对心力衰竭安全性的担忧也随之而来。在这篇综述中，我们将讨论DPP4抑制和胰高血糖素样肽-1（GLP-1）激动对心力衰竭影响的最新进展。
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