Gupta Neil, Zayyad Zaid, Bhattaram Rohan, Tiu David, Dau Jennifer, Guburxani Vidur, Kalzuna Stephanie Dwyer, Shroff Adhir R
Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 South Wood Street, Suite 929 CSB, M/C: 715, Chicago, IL, 60612, USA.
Cardiol Ther. 2025 Jul 11. doi: 10.1007/s40119-025-00426-4.
Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have emerged as a transformative class of therapies initially developed for glycemic control in type 2 diabetes mellitus. Now, they are also getting recognized for their broader cardiometabolic effects. In this review, we discuss the mechanism of action of GLP-1 RAs, focusing on their proposed cardiometabolic impact and the key clinical trials that have demonstrated improvement in cardiovascular outcomes. GLP-1 RAs have demonstrated benefits in coronary artery disease, heart failure, blood pressure, and atrial fibrillation irrespective of type 2 diabetes mellitus status, with new possible applications in peripheral arterial disease. Findings thus far have been translated into recommendations in clinical guidelines by the American College of Cardiology, American Heart Association, European Society of Cardiology, and American Diabetes Association. As GLP-1 RAs become more prevalent in treating diabetes and patients with cardiovascular disease (CVD) or risk factors for CVD, clinicians will ultimately manage the practical aspects of patient selection, dosing, special considerations, and side effects of these medications. Ongoing and future clinical trials are expected to further define the cardiovascular role of GLP-1 RAs, expand their therapeutic indications, and solidify their place in the evolving landscape of cardiovascular care.
胰高血糖素样肽1受体激动剂（GLP-1 RAs）已成为一类具有变革性的疗法，最初是为控制2型糖尿病的血糖而开发的。现在，它们因其更广泛的心脏代谢作用也得到了认可。在这篇综述中，我们讨论了GLP-1 RAs的作用机制，重点关注其推测的心脏代谢影响以及已证明能改善心血管结局的关键临床试验。无论2型糖尿病状态如何，GLP-1 RAs在冠状动脉疾病、心力衰竭、血压和心房颤动方面均已显示出益处，在外周动脉疾病中也有新的潜在应用。迄今为止的研究结果已被美国心脏病学会、美国心脏协会、欧洲心脏病学会和美国糖尿病协会纳入临床指南的建议中。随着GLP-1 RAs在治疗糖尿病以及患有心血管疾病（CVD）或有CVD风险因素的患者中越来越普遍，临床医生最终将处理这些药物在患者选择、给药、特殊注意事项和副作用等方面的实际问题。正在进行的和未来的临床试验有望进一步明确GLP-1 RAs在心血管方面的作用，扩大其治疗适应症，并巩固它们在不断发展的心血管护理领域中的地位。
