Diabetes and Endocrinology Department, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, Wales, LL13 7TD, UK.
Cardiology Department, Royal Glamorgan Hospital, Llantrisant, Wales, CF72 8XR, UK.
Heart Fail Rev. 2021 Jul;26(4):953-960. doi: 10.1007/s10741-020-09925-z.
Type 2 diabetes mellitus is associated with an increased risk of heart failure. The prevalence of type 2 diabetes mellitus is on an upward trend. Heart failure represents one of the major causes for hospitalisation and mortality despite advances in management. Recent cardiovascular outcome trials have demonstrated that sodium-glucose co-transporter 2 inhibitors, which were introduced to the market in 2013, can incur a clinically significant risk reduction in heart failure outcomes in such patients. In this review, we discuss the epidemiology and pathophysiology of heart failure in diabetes and explore the landmark trials, the potential mechanisms of benefit of SGLT-2 inhibitors in heart failure, how the trials have led to major changes in treatment guidelines, and future potential directions for use of these drugs, including in those without diabetes.
2 型糖尿病与心力衰竭风险增加相关。2 型糖尿病的患病率呈上升趋势。尽管管理水平有所提高，但心力衰竭仍然是住院和死亡的主要原因之一。最近的心血管结局试验表明，2013 年上市的钠-葡萄糖共转运蛋白 2 抑制剂可使此类患者的心力衰竭结局临床显著降低。在这篇综述中，我们讨论了糖尿病心力衰竭的流行病学和病理生理学，并探讨了里程碑式的试验、SGLT-2 抑制剂在心衰中的获益的潜在机制、试验如何导致治疗指南的重大变化，以及这些药物未来的潜在应用方向，包括在没有糖尿病的患者中。
