钠-葡萄糖协同转运蛋白2抑制剂在癌症相关心血管毒性连续过程中的潜在新应用
Potential New Applications of Sodium-Glucose Cotransporter-2 Inhibitors Across the Continuum of Cancer-Related Cardiovascular Toxicity.
作者信息
Zebrowska Agnieszka Maria, Borowiec Anna
机构信息
Cardinal Stefan Wyszynski Institute of Cardiology, 04-628 Warsaw, Poland.
Non-Commercial Clinical Trials Outpatient Clinic, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
出版信息
Pharmaceuticals (Basel). 2025 Jun 9;18(6):857. doi: 10.3390/ph18060857.
Sodium-glucose cotransporter-2 inhibitors (SGLT2i), initially developed for the management of type 2 diabetes mellitus, have demonstrated significant nephroprotective and cardioprotective effects. These benefits have led to their inclusion in heart failure (HF) management guidelines, irrespective of glycemic status and left ventricular ejection fraction (LVEF). Various anticancer therapies, particularly anthracyclines, are associated with substantial cardiotoxicity risks, resulting in cancer therapy-related cardiovascular toxicity (CTR-CVT). Promising evidence from preclinical and observational studies indicates that SGLT2i may mitigate cardiotoxic effects of cancer therapy by alleviating LVEF decline, reducing HF incidence and hospitalizations, and lowering overall mortality. Moreover, improved survival has been reported in patients with various malignancies. The current review explores the potential applications of SGLT2i in the prevention of CTR-CVT, highlights their possible mechanisms of cardioprotection, discusses the published evidence, and emphasizes the need for the results from ongoing randomized controlled trials to establish SGLT2i efficacy and safety in cardio-oncology patients.
钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)最初是为治疗2型糖尿病而开发的,现已显示出显著的肾脏保护和心脏保护作用。这些益处使其被纳入心力衰竭(HF)管理指南,无论患者的血糖状态和左心室射血分数(LVEF)如何。各种抗癌疗法,尤其是蒽环类药物,都伴有相当大的心脏毒性风险,导致癌症治疗相关的心血管毒性(CTR-CVT)。临床前和观察性研究的有力证据表明,SGLT2i可能通过减轻LVEF下降、降低HF发病率和住院率以及降低总体死亡率来减轻癌症治疗的心脏毒性作用。此外,据报道,患有各种恶性肿瘤的患者生存率有所提高。本综述探讨了SGLT2i在预防CTR-CVT方面的潜在应用,强调了其可能的心脏保护机制,讨论了已发表的证据,并强调需要正在进行的随机对照试验的结果来确定SGLT2i在心脏肿瘤患者中的疗效和安全性。