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亚太心脏病学会共识推荐:优化2型糖尿病患者的心血管结局

Consensus Recommendations by the Asian Pacific Society of Cardiology: Optimising Cardiovascular Outcomes in Patients with Type 2 Diabetes.

作者信息

Tan Jack Wei Chieh, Sim David, Ako Junya, Almahmeed Wael, Cooper Mark E, Dalal Jamshed J, Deerochanawong Chaicharn, Huang David Wei Chun, Johar Sofian, Kaul Upendra, Kim Sin Gon, Koh Natalie, Kong Alice Pik-Shan, Krittayaphong Rungroj, Kwok Bernard, Matawaran Bien J, Nguyen Quang Ngoc, Ong Loke Meng, Park Jin Joo, Peng Yongde, Quek David Kl, Suastika Ketut, Sukor Norlela, Teo Boon Wee, Teoh Chee Kiang, Zhang Jian, Reyes Eugenio B, Goh Su Yen

机构信息

National Heart Centre Singapore.

Sengkang General Hospital Singapore.

出版信息

Eur Cardiol. 2021 Apr 19;16:e14. doi: 10.15420/ecr.2020.52. eCollection 2021 Feb.

Abstract

The Asian Pacific Society of Cardiology convened a consensus statement panel for optimising cardiovascular (CV) outcomes in type 2 diabetes, and reviewed the current literature. Relevant articles were appraised using the Grading of Recommendations, Assessment, Development and Evaluation system, and consensus statements were developed in two meetings and were confirmed through online voting. The consensus statements indicated that lifestyle interventions must be emphasised for patients with prediabetes, and optimal glucose control should be encouraged when possible. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are recommended for patients with chronic kidney disease with adequate renal function, and for patients with heart failure with reduced ejection fraction. In addition to SGLT2i, glucagon-like peptide-1 receptor agonists are recommended for patients at high risk of CV events. A blood pressure target below 140/90 mmHg is generally recommended for patients with type 2 diabetes. Antiplatelet therapy is recommended for secondary prevention in patients with atherosclerotic CV disease.

摘要

亚太心脏病学会召集了一个关于优化2型糖尿病患者心血管(CV)结局的共识声明小组,并对当前文献进行了回顾。使用推荐分级、评估、制定与评价系统对相关文章进行了评估,并在两次会议上制定了共识声明,并通过在线投票得到确认。共识声明指出,对于糖尿病前期患者必须强调生活方式干预,并尽可能鼓励实现最佳血糖控制。对于肾功能正常的慢性肾病患者以及射血分数降低的心力衰竭患者,推荐使用钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)。除SGLT2i外,对于心血管事件高危患者,推荐使用胰高血糖素样肽-1受体激动剂。一般建议2型糖尿病患者的血压目标低于140/90 mmHg。对于动脉粥样硬化性心血管疾病患者,推荐进行抗血小板治疗以二级预防。

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