Moady Gassan, Ben Gal Tuvia, Atar Shaul
Department of Cardiology, Galilee Medical Center, Nahariya 2210001, Israel.
Azrieli Faculty of Medicine, Bar Ilan University, Safed 5290002, Israel.
Life (Basel). 2023 May 25;13(6):1256. doi: 10.3390/life13061256.
Sodium-glucose co-transporter 2 (SGLT2) inhibitors, originally used for diabetes mellitus, are gaining more popularity for other indications, owing to their positive cardiovascular and renal effects. SGLT2 inhibitors reduce heart failure (HF) hospitalization and improve cardiovascular outcomes in patients with type 2 diabetes. Later, SGLT2 inhibitors were evaluated in patients with HF with reduced ejection fraction (HFREF) and had beneficial effects independent of the presence of diabetes. Recently, reductions in cardiovascular outcomes were also observed in patients with HF with preserved ejection fraction (HFPEF). SGLT2 inhibitors also reduced renal outcomes in patients with chronic kidney disease. Overall, these drugs have an excellent safety profile with a negligible risk of genitourinary tract infections and ketoacidosis. In this review, we discuss the current data on SGLT2 inhibitors in special populations, including patients with acute myocardial infarction, acute HF, right ventricular (RV) failure, left ventricular assist device (LVAD), and type 1 diabetes. We also discuss the potential mechanisms behind the cardiovascular benefits of these medications.
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂最初用于治疗糖尿病，由于其对心血管和肾脏的积极作用，在其他适应症方面越来越受欢迎。SGLT2抑制剂可减少2型糖尿病患者的心衰（HF）住院率并改善心血管结局。后来，在射血分数降低的心衰（HFREF）患者中对SGLT2抑制剂进行了评估，发现其有益作用与糖尿病的存在无关。最近，在射血分数保留的心衰（HFPEF）患者中也观察到心血管结局有所改善。SGLT2抑制剂还降低了慢性肾病患者的肾脏不良结局。总体而言，这些药物具有出色的安全性，发生泌尿生殖道感染和酮症酸中毒的风险可忽略不计。在本综述中，我们讨论了SGLT2抑制剂在特殊人群中的现有数据，包括急性心肌梗死、急性心衰、右心室（RV）衰竭、左心室辅助装置（LVAD）和1型糖尿病患者。我们还讨论了这些药物心血管获益背后的潜在机制。
