Tanaka Atsushi, Node Koichi
Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501 Japan.
Diabetol Int. 2020 Jun 11;11(3):252-260. doi: 10.1007/s13340-020-00445-7. eCollection 2020 Jul.
In recent years, successive reports have been made on large-scale cardiovascular outcome trials using novel hypoglycemic drugs. Their results have shown that sodium-glucose cotransporter 2 (SGLT2) inhibitors are hypoglycemic drugs that could potentially greatly improve the heart failure-related outcomes in type 2 diabetes patients with a high cardiovascular risk. Further analyses have subsequently been performed from various perspectives, and SGLT2 inhibitors with their class effect have been indicated to be potentially useful for heart failure in type 2 diabetes patients with extensive clinical background. As a result, a clear concept has globally emerged with SGLT2 inhibitors as drugs of choice in clinical practice to prevent heart failure in type 2 diabetes patients. Further studies are needed to examine the next research topics on heart failure prevention using SGLT2 inhibitors, including their detailed pharmacological mechanism of action and their effectiveness and safety against heart failure in patients regardless of diabetes status. This paper outlines (1) the current evidence of heart failure prevention by SGLT2 inhibitors based on the results of recent large-scale cardiovascular outcome trials and (2) future research topics on their further applications in clinical practice.
近年来，陆续有关于使用新型降糖药物的大规模心血管结局试验的报道。其结果表明，钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂是一类降糖药物，有可能极大地改善心血管风险较高的2型糖尿病患者与心力衰竭相关的结局。随后从各种角度进行了进一步分析，具有类效应的SGLT2抑制剂已被证明对具有广泛临床背景的2型糖尿病患者的心力衰竭可能有用。因此，在全球范围内已形成一个明确的概念，即SGLT2抑制剂是临床实践中预防2型糖尿病患者心力衰竭的首选药物。需要进一步研究以探讨使用SGLT2抑制剂预防心力衰竭的下一个研究课题，包括其详细的药理作用机制以及无论糖尿病状态如何，其对患者心力衰竭的有效性和安全性。本文概述了（1）基于近期大规模心血管结局试验结果的SGLT2抑制剂预防心力衰竭的当前证据，以及（2）其在临床实践中进一步应用的未来研究课题。
