MacIsaac Richard J
Director of Endocrinology & Diabetes, St Vincent's Hospital Melbourne & Professorial Fellow University of Melbourne, Victoria, Australia.
Australian Centre For Accelerating Diabetes Innovations, University of Melbourne, Melbourne, Victoria, Australia.
Future Cardiol. 2025 Jul;21(9):663-683. doi: 10.1080/14796678.2025.2511412. Epub 2025 Jun 3.
Recent trials underscore the cardiovascular (CV), renal, and metabolic benefits of semaglutide in individuals with and without type 2 diabetes (T2D). In T2D, semaglutide enhances glycemic control, reduces major adverse CV events (MACE), and slows chronic kidney disease (CKD) progression. The SUSTAIN-6 trial demonstrated a 26% MACE reduction (HR 0.74; 95% CI: 0.58-0.95; = 0.02) in high CV-risk patients with T2D using semaglutide (0.5 or 1.0 mg weekly). Similarly, the FLOW trial showed a 24% reduction in major kidney disease events (HR 0.76; 95% CI: 0.66-0.88; = 0.002) with weekly 1.0 mg semaglutide in individuals with T2D with CKD. Beyond T2D, the SELECT trial highlighted semaglutide's efficacy in reducing MACE by 20% (HR 0.80; 95% CI: 0.72-0.90; < 0.001) and slowing kidney function loss in overweight or obese individuals with preexisting CV disease using 2.4 mg weekly. Additionally, semaglutide alleviates heart failure symptoms and reduces hospitalizations in obese individuals regardless of T2D status. These findings underscore semaglutide's role in improving kidney, CV, and survival outcomes among high-risk patients. This review highlights the cardio-kidney-metabolic benefits of semaglutide in individuals with and without T2D to inform cardiologists about its potential to enhance patient care.
近期试验强调了司美格鲁肽对患有和未患有2型糖尿病（T2D）个体的心血管（CV）、肾脏和代谢方面的益处。在T2D患者中，司美格鲁肽可改善血糖控制，减少主要不良心血管事件（MACE），并减缓慢性肾脏病（CKD）进展。SUSTAIN-6试验表明，使用司美格鲁肽（每周0.5或1.0毫克）的T2D高CV风险患者的MACE降低了26%（HR 0.74；95%CI：0.58-0.95；P = 0.02）。同样，FLOW试验显示，T2D合并CKD患者每周使用1.0毫克司美格鲁肽，主要肾脏疾病事件减少24%（HR 0.76；95%CI：0.66-0.88；P = 0.002）。在T2D之外，SELECT试验强调了司美格鲁肽对MACE的疗效，可降低20%（HR 0.80；95%CI：0.72-0.90；P < 0.001），并减缓已有CV疾病的超重或肥胖个体的肾功能丧失，使用剂量为每周2.4毫克。此外，无论T2D状态如何，司美格鲁肽均可减轻肥胖个体的心力衰竭症状并减少住院次数。这些发现强调了司美格鲁肽在改善高危患者肾脏、CV和生存结局方面的作用。本综述强调了司美格鲁肽对患有和未患有T2D个体的心脏-肾脏-代谢益处，以便让心脏病专家了解其改善患者护理的潜力。
