Galati Giuseppe, Sabouret Pierre, Germanova Olga, Bhatt Deepak L
Heart Failure Unit and Division of Cardiology, Cardiothoracic and Vascular Department, San Raffaele Hospital and Scientific Institute (IRCCS) Milan, Italy.
Heart Institute, Cardiology Department, Pitié-Salpétrière, Sorbonne University and Collège National des Cardiologues Français Paris, France.
Eur Cardiol. 2021 Oct 21;16:e40. doi: 10.15420/ecr.2021.22. eCollection 2021 Feb.
Despite major advances in cardiovascular research over the past decade, women with type 2 diabetes have a high risk of cardiovascular events. Several factors contribute to the poor prognosis for women, including higher levels of frailty and comorbidities, but their cardiovascular risk is underestimated and there is suboptimal implementation and uptitration of new evidence-based therapies, leading to high morbidity and mortality. Recent studies highlight the need for better management of diabetes in women that can be pursued and achieved in light of recent results from randomised controlled trials demonstrating evidence of the benefits of new therapeutic strategies in improving cardiovascular outcomes and quality of life of women covering the entire cardiovascular continuum. This review critically discusses the multiple benefits for women of new pharmacological treatments, such as glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter type 2 inhibitors (SGLT2i), proprotein convertase subtilisin/kexin type 9 inhibitors, inclisiran, icosapent ethyl and bempedoic acid in preventing cardiovascular events, and treatments, such as angiotensin receptor neprilysin inhibitors, SGLT2i, vericiguat and omecamtiv mecarbil, for preventing heart failure.
尽管在过去十年中心血管研究取得了重大进展,但2型糖尿病女性发生心血管事件的风险仍然很高。有几个因素导致了女性预后不良,包括更高的虚弱程度和合并症,但她们的心血管风险被低估,新的循证疗法的实施和滴定不足,导致高发病率和死亡率。最近的研究强调,鉴于随机对照试验的最新结果表明新治疗策略在改善整个心血管连续过程中女性的心血管结局和生活质量方面的益处,需要对女性糖尿病进行更好的管理,这是可以追求并实现的。本综述批判性地讨论了新的药物治疗对女性的多重益处,例如胰高血糖素样肽-1受体激动剂、钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)、前蛋白转化酶枯草溶菌素/kexin 9型抑制剂、inclisiran、二十碳五烯酸乙酯和贝派地酸在预防心血管事件方面的作用,以及血管紧张素受体脑啡肽酶抑制剂、SGLT2i、维立西呱和奥麦卡替麦角在预防心力衰竭方面的治疗作用。