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钠-葡萄糖协同转运蛋白2抑制剂与动脉粥样硬化

Sodium-glucose cotransporter 2 inhibitors and atherosclerosis.

作者信息

Ceasovschih Alexandr, Balta Anastasia, Aldeen Essam Shams, Bianconi Vanessa, Barkas Fotios, Şener Yusuf Ziya, Jakubová Marta, Yilmaz Mehmet Birhan, Banach Maciej, Șorodoc Laurențiu, Șorodoc Victorița

机构信息

Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, Iasi, Romania.

Department of Internal Medicine, 'Sf. Spiridon' Clinical Emergency Hospital, Iasi, Romania.

出版信息

Am J Prev Cardiol. 2025 Jul 18;23:101061. doi: 10.1016/j.ajpc.2025.101061. eCollection 2025 Sep.

Abstract

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have emerged as a promising therapeutic class in cardiovascular disease. This review synthesizes clinical and preclinical evidence on their effects on atherosclerosis, arterial stiffness and related conditions, including dyslipidemia, coronary artery disease, peripheral artery disease, and stroke. The atheroprotective advantages of SGLT2i are attributed to multiple mechanisms, including modulation of inflammatory pathways, improvements in vascular function, and reductions in oxidative stress, in addition to enhanced glycemic control, weight reduction, antihypertensive, and antifibrotic effects. Recent studies highlight their minimal adverse effects and compatibility for combination therapies, further expanding their clinical applications. SGLT2i have redefined the landscape of cardiovascular treatment through their extensive range of benefits, offering significant promise in optimizing outcomes for patients with atherosclerotic cardiovascular disease. By setting new standards of care and maintaining a favorable safety profile, these agents continue to advance the paradigm of cardiovascular disease management. While definitive conclusions require further investigation, SGLT2i have become serious contenders in the argument for antiatherosclerotic effects, with accumulating evidence suggesting their positive influence.

摘要

钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)已成为心血管疾病治疗领域中一类颇具前景的药物。本综述综合了临床和临床前证据,阐述了其对动脉粥样硬化、动脉僵硬度及相关病症(包括血脂异常、冠状动脉疾病、外周动脉疾病和中风)的影响。SGLT2i的动脉粥样硬化保护优势归因于多种机制,除了改善血糖控制、减轻体重、降低血压和抗纤维化作用外,还包括调节炎症途径、改善血管功能以及减轻氧化应激。近期研究凸显了其不良反应极少且适合联合治疗,进一步拓展了其临床应用。SGLT2i凭借其广泛的益处重新定义了心血管治疗格局,为优化动脉粥样硬化性心血管疾病患者的治疗结局带来了巨大希望。通过设定新的护理标准并保持良好的安全性,这些药物不断推动心血管疾病管理模式的发展。虽然得出确定性结论还需要进一步研究,但SGLT2i已成为抗动脉粥样硬化作用争论中的有力竞争者,越来越多的证据表明它们具有积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/195b/12329282/16474ee0ac67/ga1.jpg

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