SGLT2 抑制剂与心力衰竭——当前的概念。
SGLT2 inhibition and heart failure-current concepts.
机构信息
Department of Health Family, Medical School of Bahia, Federal University of Bahia, Praça XV de Novembro, s/n° - Largo do Terreiro de Jesus, Salvador, BA, 40026-010, Brazil.
Post-graduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, BA, Brazil.
出版信息
Heart Fail Rev. 2018 May;23(3):409-418. doi: 10.1007/s10741-018-9703-2.
Type 2 diabetes mellitus (T2DM) is a major risk factor for several cardiovascular (CV) conditions, including heart failure (HF). However, until recently, no therapy to treat patients with diabetes could also reduce CV risks related to HF. The EMPA-REG OUTCOME trial with empagliflozin was the first to demonstrate significant cardioprotective benefits in this population. Its impressive 35% reduction in hospitalizations for HF drew the attention of the scientific community to the possibility that pharmacologic sodium-glucose cotransporter 2 (SGLT2) inhibition could be part of the armamentarium for treating patients with HF, with and without diabetes. The recently published CANVAS Program (with canagliflozin) and real-life data from the CVD-Real Study (using dapagliflozin, empagliflozin, and canagliflozin) further strengthened this hypothesis, suggesting that the observed benefit is not restricted to a particular drug, but is rather a class effect. This review explores the effects of pharmacologic SGLT2 inhibitors' use in cardiac function and discusses the potential role of this class of medication as a treatment for HF.
2 型糖尿病（T2DM）是多种心血管（CV）疾病的主要危险因素，包括心力衰竭（HF）。然而，直到最近，还没有专门针对糖尿病患者的治疗方法可以降低与 HF 相关的 CV 风险。恩格列净的 EMPA-REG OUTCOME 试验首次证明了该人群的显著心脏保护益处。其对 HF 住院治疗的 35%的降幅引起了科学界的关注，即药物钠-葡萄糖协同转运蛋白 2（SGLT2）抑制剂可能成为治疗伴有或不伴有糖尿病 HF 患者的治疗手段之一。最近公布的 CANVAS 项目（使用卡格列净）和 CVD-Real 研究的真实数据（使用达格列净、恩格列净和卡格列净）进一步证实了这一假设，表明观察到的益处不仅限于特定药物，而是一种药物类别效应。本综述探讨了药理 SGLT2 抑制剂在心脏功能中的作用，并讨论了该类药物作为 HF 治疗药物的潜在作用。
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