The Effects and the Mechanisms of Sodium Glucose Cotransporter-2 Inhibition in Heart Failure

Lei Zhou, H. Gong
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引用次数: 18

Abstract

Individuals with diabetes are not only with high risk of developing heart failure but also with increased risk of death [1]. Different types of hypoglycemic drugs have different cardiovascular safety, so it is necessary to evaluate the cardiovascular safety of new hypoglycemic drugs. In recent years, many large-scale randomized controlled trials on SGLT2 inhibitors for oral hypoglycemic agents such as (EMPA-REG OUTCOME (The Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes Trial); CANVAS Program (The Canagliflozin Cardiovascular Assessment Study Program); DEGLARE-TIMI 58 (The Dapagliflozin Effect on Cardiovascular Events -TIMI 58 Trial); DEFINE-HF Trial (The Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure Trial) have shown that SGLT2 inhibitors could significantly reduce the hospitalization rate and the composite endpoint of cardiovascular mortality in patients with heart failure compared to the placebo group [2-5]. This effect persisted even in non-diabetic patients. The mechanisms responsible for the cardioprotective effects of SGLT2 inhibitors remain uncertain. This article summarizes the possible mechanisms of SGLT2 inhibitors in heart failure as follows. The Biological Role of SGLT2
葡萄糖共转运蛋白-2钠抑制心力衰竭的作用及机制
糖尿病患者不仅发生心力衰竭的风险高,而且死亡风险也增加[1]。不同类型的降糖药具有不同的心血管安全性,因此有必要对新型降糖药的心血管安全性进行评价。近年来,许多关于SGLT2抑制剂用于口服降糖药的大规模随机对照试验,如EMPA-REG结局(恩格列净、心血管结局和2型糖尿病死亡率试验);CANVAS项目(canag列净心血管评估研究项目);达格列净对心血管事件的影响-TIMI 58试验;DEFINE-HF试验(The Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure Trial)表明,与安慰剂组相比,SGLT2抑制剂可显著降低心力衰竭患者的住院率和心血管死亡率的综合终点[2-5]。这种效果甚至在非糖尿病患者中也持续存在。SGLT2抑制剂的心脏保护作用机制仍不确定。本文总结了SGLT2抑制剂在心力衰竭中的可能机制。SGLT2的生物学作用
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