De Luca Leonardo, Bilato Claudio, Navazio Alessandro, Corda Marco, Milli Massimo, Scicchitano Pietro, Di Marco Massimo, Riccio Carmine, Geraci Giovanna, Iacovoni Attilio, Pascale Vittorio, Tizzani Emanuele, Gabrielli Domenico, Grimaldi Massimo, Colivicchi Furio, Oliva Fabrizio
S.C. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
U.O.C. Cardiologia, Ospedali dell'Ovest Vicentino, Azienda ULSS 8 Berica, Vicenza, Italy.
Eur Heart J Suppl. 2025 May 15;27(Suppl 5):v247-v255. doi: 10.1093/eurheartjsupp/suaf071. eCollection 2025 May.
Semaglutide, a glucagon-like peptide-1 receptor agonist, has emerged as a pivotal therapeutic agent in the management of the cardio-renal-metabolic continuum. Initially developed for glycaemic control in Type 2 diabetes mellitus, its benefits extend far beyond glucose regulation. Clinical trials have demonstrated semaglutide's potential to reduce major adverse cardiovascular events, particularly in overweight/obese patients with high cardiovascular risk, as well as improving functional capacity in patients suffering from heart failure with preserved left ventricular function. Additionally, it has shown promise in improving renal outcomes, such as slowing the progression of albuminuria and reducing the risk of chronic kidney disease in diabetic populations. These effects are likely due to its multifaceted mechanisms, including anti-inflammatory properties, weight reduction, blood pressure lowering, and direct renal protection. This review synthesizes current evidence on semaglutide's role in the interrelated domains of cardiovascular, renal, and metabolic health.
司美格鲁肽是一种胰高血糖素样肽-1受体激动剂,已成为管理心血管、肾脏和代谢连续体的关键治疗药物。它最初是为控制2型糖尿病的血糖而开发的,其益处远不止于血糖调节。临床试验表明,司美格鲁肽有降低主要不良心血管事件的潜力,尤其是在心血管风险高的超重/肥胖患者中,并且还能改善左心室功能保留的心力衰竭患者的功能能力。此外,它在改善肾脏结局方面也显示出前景,例如减缓糖尿病患者蛋白尿的进展并降低患慢性肾脏病的风险。这些作用可能归因于其多方面的机制,包括抗炎特性、体重减轻、血压降低和直接的肾脏保护作用。本综述综合了关于司美格鲁肽在心血管、肾脏和代谢健康相关领域作用的现有证据。