Kocyigit Duygu, Gurses Kadri Murat, Yalcin Muhammed Ulvi, Tokgozoglu Lale
Department of Cardiology, Hacettepe University, Faculty of Medicine, 06100 Sihhiye, Ankara, Turkey.
Cardiology Clinics, Konya Training and Research Hospital, 42090, Meram Konya, Turkey.
Endocr Metab Immune Disord Drug Targets. 2017;17(1):19-31. doi: 10.2174/1871530317666170424101846.
Type 2 diabetic patients are known to have a tendency to develop cardiovascular (CV) disease (CVD), and related unfavourable outcomes such as heart failure, myocardial infarction (MI), cerebrovascular events (e.g. stroke), and related mortality. Long- term clinical trials have revealed contradictory findings regarding the relationship between glycemic control and CV benefits due to variations in the key characteristics of the study population. During the last decade, number of pharmacological agents used for glucose- lowering in the treatment of type 2 diabetes mellitus (T2DM) has increased owing to the introduction of dipeptidyl peptidase- IV (DPP- IV) inhibitors, glucagon- like peptide- 1 (GLP- 1) receptor agonists, and sodium-glucose co-transporter 2 (SGLT- 2) inhibitors. This review aims to focus on the mechanisms of action of these drugs in the cardiovascular system and the trials evaluating their impact on CVD. Furthermore, trials in the last decade evaluating the impact of traditional glucose- lowering drugs on CVD are included. For this purpose, we searched PubMed for articles in English using the search terms "type 2 diabetes mellitus, glucose- lowering drugs, antidiabetic medications, cardiovascular, cardiovascular disease, cardiovascular system" between inception to September 2016. We also searched separately for each medication in addition to the keyword "cardiovascular disease" on PubMed. To identify further articles, we hand searched related citations in review articles and commentaries.
众所周知，2型糖尿病患者有发生心血管疾病（CVD）的倾向，以及出现相关不良后果，如心力衰竭、心肌梗死（MI）、脑血管事件（如中风）和相关死亡率。由于研究人群关键特征的差异，长期临床试验在血糖控制与心血管获益之间的关系上得出了相互矛盾的结果。在过去十年中，由于二肽基肽酶-IV（DPP-IV）抑制剂、胰高血糖素样肽-1（GLP-1）受体激动剂和钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂的引入，用于2型糖尿病（T2DM）治疗的降糖药物数量有所增加。本综述旨在关注这些药物在心血管系统中的作用机制以及评估它们对CVD影响的试验。此外，还纳入了过去十年中评估传统降糖药物对CVD影响的试验。为此，我们在PubMed上使用检索词“2型糖尿病、降糖药物、抗糖尿病药物、心血管、心血管疾病、心血管系统”检索了从创刊到2016年9月的英文文章。除了在PubMed上使用关键词“心血管疾病”外，我们还分别对每种药物进行了检索。为了识别更多文章，我们人工检索了综述文章和评论中的相关参考文献。
