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心脏糖尿病专家:不仅仅是血糖水平的问题。

The cardiodiabetologist: not just a question of blood glucose levels.

作者信息

Muscente Francesca, De Caterina Raffaele

机构信息

Floraspe-Renzetti Hospital, ASL Lanciano-Vasto-Chieti, Lanciano, Italy.

University of Pisa, Pisa, Italy.

出版信息

Eur Heart J Suppl. 2025 Apr 16;27(Suppl 3):iii89-iii92. doi: 10.1093/eurheartjsupp/suaf022. eCollection 2025 Mar.

Abstract

Following the publication of numerous cardiovascular outcome studies conducted with new glucose-lowering agents, there has been a substantial change in the treatment paradigm of patients with type 2 diabetes, shifting the focus from simple glycaemic control to cardiovascular risk management. National and international guidelines of cardiology and diabetes societies have now acknowledged the important cardioprotective effects of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide receptor agonists, to the point that they are now considered first-line drugs in the management of cardiovascular risk in high-risk patients or with established cardiovascular disease, and also outside the context of established diabetes. In this brief review, we will analyse the clinical and pathophysiological evidence underlying this important paradigm shift, hypothesizing their early use in many cardiovascular patients, particularly in the pre-diabetes phase. Overall, these drugs are now a cornerstone in the therapeutic armamentarium, which the cardiologist must fully master, even independently of diabetologists.

摘要

随着众多使用新型降糖药物进行的心血管结局研究的发表,2型糖尿病患者的治疗模式发生了重大变化,从单纯的血糖控制转向心血管风险管理。心脏病学和糖尿病学会的国家和国际指南现在已经认可了钠-葡萄糖协同转运蛋白2抑制剂和胰高血糖素样肽受体激动剂的重要心脏保护作用,以至于它们现在被认为是高危患者或已确诊心血管疾病患者心血管风险管理的一线药物,甚至在未确诊糖尿病的情况下也是如此。在这篇简短的综述中,我们将分析这一重要模式转变背后的临床和病理生理学证据,并推测它们在许多心血管患者中的早期应用,特别是在糖尿病前期阶段。总体而言,这些药物现在是治疗武器库中的基石,心脏病专家必须完全掌握,甚至独立于糖尿病专家。

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