Second Department of Cardiology, General Hospital "Hippokration", Aristotle University of Thessaloniki, Thessaloniki, Greece.
Second Propedeutic Department of Internal Medicine, General Hospital "Hippokration", Aristotle University of Thessaloniki, Thessaloniki, Greece.
Curr Pharm Des. 2024;30(27):2109-2119. doi: 10.2174/0113816128304097240529053538.
Atherosclerotic Cardiovascular Disease (ASCVD) is still one of the leading causes of death globally, with Coronary Artery Disease (CAD) being the most prevalent form of ASCVD. Patients with type 2 Diabetes Mellitus (DM) experience an increased risk for ASCVD during the disease course, with CAD being the most common cause of death among affected individuals, resulting in shorter life expectancy and increased morbidity among survivors. Recently, 2 novel classes of anti-diabetic drugs, namely Sodium-Glucose Co-Transporter- 2 (SGLT-2) inhibitors and Glucagon-Like Peptide-1 (GLP-1) receptor agonists, have shown impressive cardio-renal benefits for patients with type 2 DM, while they might decrease cardio-renal risk even in the absence of baseline DM. However, there is no evidence to date regarding their safety and efficacy in the setting of an acute coronary syndrome (ACS) event, regardless of concomitant DM. This study aims to provide a detailed, updated presentation of currently available clinical evidence concerning the potential role of SGLT-2 inhibitors and GLP-1 receptor agonists in the setting of an ACS, and to highlight whether those drug classes could be utilized as adjuncts to standard-of-care treatment in this specific patient population, along with a presentation of the potential short- and long-term cardiovascular benefits.
动脉粥样硬化性心血管疾病(ASCVD)仍然是全球主要的死亡原因之一,其中冠状动脉疾病(CAD)是 ASCVD 最常见的形式。2 型糖尿病(DM)患者在疾病过程中发生 ASCVD 的风险增加,CAD 是受影响个体中最常见的死亡原因,导致预期寿命缩短和幸存者发病率增加。最近,两类新型抗糖尿病药物,即钠-葡萄糖共转运蛋白 2(SGLT-2)抑制剂和胰高血糖素样肽-1(GLP-1)受体激动剂,已显示出对 2 型 DM 患者的令人印象深刻的心肾获益,而即使在没有基线 DM 的情况下,它们也可能降低心肾风险。然而,目前尚无关于这些药物在急性冠状动脉综合征(ACS)事件中的安全性和疗效的证据,无论是否同时存在 DM。本研究旨在详细介绍目前关于 SGLT-2 抑制剂和 GLP-1 受体激动剂在 ACS 背景下的潜在作用的临床证据,并强调这些药物类别是否可以作为该特定患者群体标准治疗的辅助手段,同时介绍潜在的短期和长期心血管获益。