Cleveland Clinic, Department of Endocrinology, Diabetes and Metabolism, 9500 Euclid Ave. F20, Cleveland, OH, 44195, USA.
Cleveland Clinic, Department of Cardiovascular Medicine, 9500 Euclid Ave. J1-5, Cleveland, OH, 44195, USA.
Curr Cardiol Rep. 2018 Jun 21;20(8):65. doi: 10.1007/s11886-018-1005-8.
We review the cardiovascular and renal outcomes and safety of newer anti-diabetic medications in high-risk patients. We examine the outcomes of the IRIS, EMPA-REG OUTCOME, CANVAS, LEADER, SAVOR-TIMI 53, and EXAMINE trials demonstrating the cardiovascular and renal benefits of thiazolidinediones, SGLT2 inhibitors, GLP-1 agonists, and DPP-4 inhibitors.
Diabetes mellitus is a leading risk factor for cardiovascular disease with rising prevalence and disease burden. The microvascular and macrovascular complications of diabetes are well-recognized and include increased risk of cardiovascular disease, myocardial infarction, and stroke. Newer diabetes medications have demonstrated significant cerebrovascular, cardiovascular, renal, and mortality benefits in high risk patients with diabetes. In addition to their glucose-lowering effects, the thiazolidinedione pioglitazone, SGLT2 inhibitors, GLP-1 agonist, and DPP-4 inhibitors have demonstrated significant cerebrovascular, cardiovascular, renal, and mortality effects. The outcomes and safety data of newer diabetes medications from recent trials demonstrate cardiovascular and mortality effects with significant implications for clinical practice.
我们回顾了高危患者中新型抗糖尿病药物的心血管和肾脏结局及安全性。我们研究了 IRIS、EMPA-REG OUTCOME、CANVAS、LEADER、SAVOR-TIMI 53 和 EXAMINE 试验的结果，这些试验证明了噻唑烷二酮类、SGLT2 抑制剂、GLP-1 激动剂和 DPP-4 抑制剂在心血管和肾脏方面的获益。
糖尿病是心血管疾病的主要危险因素，其患病率和疾病负担不断上升。糖尿病的微血管和大血管并发症是众所周知的，包括心血管疾病、心肌梗死和中风风险增加。新型糖尿病药物在伴有糖尿病的高危患者中显示出显著的脑血管、心血管、肾脏和死亡率获益。除了降低血糖的作用外，噻唑烷二酮类吡格列酮、SGLT2 抑制剂、GLP-1 激动剂和 DPP-4 抑制剂也显示出显著的脑血管、心血管、肾脏和死亡率效应。最近试验中新型糖尿病药物的结果和安全性数据显示出心血管和死亡率效应，对临床实践具有重要意义。
