Division of Cardiovascular Medicine, University of Utah Health, Salt Lake City, Utah 84132, USA; email:
Annu Rev Pharmacol Toxicol. 2022 Jan 6;62:109-120. doi: 10.1146/annurev-pharmtox-052120-014725. Epub 2021 Sep 13.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve blood glucose control by blocking renal glucose reabsorption with little subsequent risk of hypoglycemia. Consequently, there are decreases in plasma volume, body weight, and blood pressure. Additional putative benefits include improved cardiovascular energetics, decreased systemic inflammation, and less renal dysfunction. Multiple cardiovascular outcome trials in diabetic patients have demonstrated this drug class reduces the risk of adverse cardiovascular events. Reductions in heart failure (HF) hospitalization suggested that SGLT2 inhibitors might prove useful for the primary treatment of HF. Two large subsequent trials studying SGLT2 inhibitors in heart failure with reduced ejection fraction (HFrEF) demonstrated a reduction in cardiovascular mortality, HF hospitalizations, and renal-specific adverse events. This medication class is now recognized as a new pillar of therapy for patients with HFrEF. The cardiovascular and HF community await the results of ongoing trials of SGLT2 inhibition in patients with HF with preserved ejection fraction.
钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂通过阻断肾脏对葡萄糖的重吸收来改善血糖控制，几乎没有低血糖的风险。因此，血浆体积、体重和血压都会下降。额外的潜在益处包括改善心血管能量学、降低全身炎症和减少肾功能障碍。多项糖尿病患者的心血管结局试验表明，该药物类别降低了不良心血管事件的风险。心力衰竭（HF）住院率的降低表明，SGLT2 抑制剂可能对 HF 的主要治疗有用。两项随后研究 SGLT2 抑制剂在射血分数降低的心力衰竭（HFrEF）中的大型试验表明，心血管死亡率、HF 住院率和肾脏特异性不良事件均有所降低。该药物类别现已被公认为 HFrEF 患者治疗的新支柱。心血管和 HF 领域正在等待 SGLT2 抑制在射血分数保留的心力衰竭（HFpEF）患者中进行的临床试验结果。
