Wang Andy, Mahmood Uzair, Dey Subo, Fishkin Tzvi, Frishman William H, Aronow Wilbert S
From the Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY.
Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY.
Cardiol Rev. 2025;33(1):22-26. doi: 10.1097/CRD.0000000000000554. Epub 2023 Apr 18.
Cardiovascular disease is a major cause of morbidity and mortality worldwide in patients with type 2 diabetes. Type 2 diabetes confers an elevated risk of developing heart failure and atherosclerotic cardiovascular disease. Until recently, there have been limited options to prevent and reduce the cardiovascular complications of type 2 diabetes. However, recent therapeutic advances have led to the adoption of sodium-glucose co-transporter 2 inhibitors (SGLT2i) in cardiovascular management. Though SGLT2i were originally used for antihyperglycemic treatment, a series of landmark trials found that SGLT2i may confer cardio-protective effects in patients with heart failure and atherosclerotic cardiovascular disease, particularly a reduction in cardiovascular mortality and hospitalizations for heart failure. The cardiovascular benefits of SGLT2i were similarly demonstrated in patients with and without type 2 diabetes. Though previous trials found SGLT2i to be cardio-protective in heart failure with reduced ejection fraction, recent trials demonstrated that SGLT2i may also provide cardiovascular benefits in heart failure with mildly reduced and preserved ejection fraction. These advances have led SGLT2i to become an instrumental component of cardiovascular therapy.
心血管疾病是全球2型糖尿病患者发病和死亡的主要原因。2型糖尿病会增加患心力衰竭和动脉粥样硬化性心血管疾病的风险。直到最近，预防和减少2型糖尿病心血管并发症的选择仍然有限。然而，最近的治疗进展使得钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）被应用于心血管疾病管理。虽然SGLT2i最初用于抗高血糖治疗，但一系列具有里程碑意义的试验发现，SGLT2i可能对心力衰竭和动脉粥样硬化性心血管疾病患者具有心脏保护作用，特别是可降低心血管死亡率和心力衰竭住院率。SGLT2i对有或没有2型糖尿病的患者都有类似的心血管益处。尽管之前的试验发现SGLT2i对射血分数降低的心力衰竭患者具有心脏保护作用，但最近的试验表明，SGLT2i对射血分数轻度降低和保留的心力衰竭患者也可能具有心血管益处。这些进展使SGLT2i成为心血管治疗的重要组成部分。
