Mitigating heart failure risk in patients with diabetes and chronic kidney disease.

IF 2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Opinion in Cardiology Pub Date : 2025-05-01 Epub Date: 2025-02-12 DOI:10.1097/HCO.0000000000001208

Nicholas S Kowalczyk, Megan Prochaska

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引用次数: 0

Abstract

Purpose of review: Patients with chronic kidney disease and diabetes are at high risk of cardiovascular disease, including heart failure. Risk mitigation requires a comprehensive approach with lifestyle modifications, blood pressure management, renin-angiotensin blockade, and sodium-glucose cotransporter 2 inhibitors. Recent trials have shown that nonsteroidal mineralocorticoid receptor antagonists (ns-MRA) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) should also be components of this approach. This review will discuss the comprehensive approach to mitigating risk in these high-risk patients and highlight the recent trials of ns-MRAs and GLP-1 RA.

Recent findings: In recent years, large, randomized controlled trials of ns-MRA and GLP-1 RA have shown benefit in kidney and cardiovascular outcomes for patients with chronic kidney disease and diabetes.

Summary: The substantial benefits and overall favorable safety profiles for ns-MRA and GLP-1 RA in patients with chronic kidney disease and diabetes demonstrate that these medications should be considered as a part of a comprehensive approach to cardiovascular risk reduction in this high-risk population. Future studies should consider different combination therapies and guide how and when to initiate these therapies.

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减轻糖尿病和慢性肾脏疾病患者心力衰竭的风险。

综述目的：慢性肾脏疾病和糖尿病患者是心血管疾病（包括心力衰竭）的高危人群。降低风险需要综合的方法，包括改变生活方式、控制血压、肾素-血管紧张素阻滞剂和钠-葡萄糖共转运蛋白2抑制剂。最近的试验表明，非甾体矿皮质激素受体拮抗剂（ns-MRA）和胰高血糖素样肽1受体激动剂（GLP-1 RA）也应该是该方法的组成部分。本综述将讨论降低这些高危患者风险的综合方法，并重点介绍nsmras和GLP-1 RA的最新试验。最近发现：近年来，大型随机对照试验表明，ns-MRA和GLP-1 RA对慢性肾病和糖尿病患者的肾脏和心血管预后有益处。总结：ns-MRA和GLP-1 RA在慢性肾脏疾病和糖尿病患者中的巨大益处和总体有利的安全性表明，这些药物应被视为降低这一高危人群心血管风险的综合方法的一部分。未来的研究应考虑不同的联合治疗，并指导如何以及何时开始这些治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Cardiology 医学-心血管系统

CiteScore

4.20

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Cardiology is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With fourteen disciplines published across the year – including arrhythmias, molecular genetics, HDL cholesterol and clinical trials – every issue also contains annotated reference detailing the merits of the most important papers.