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Mechanistic insights regarding the role of SGLT2 inhibitors and GLP1 agonist drugs on cardiovascular disease in diabetes.
Progress in Cardiovascular Diseases ( IF 9.1 ) Pub Date : 2019-08-02 , DOI: 10.1016/j.pcad.2019.07.005
Vinay Garg 1 , Subodh Verma 2 , Kim Connelly 3
Affiliation  

The treatment landscape for patients with established or at high risk for cardiovascular disease and type 2 diabetes mellitus has entirely changed over the past decade, with the introduction of several anti-hyperglycemic agents. Sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) agonists are two anti-hyperglycemic classes which have been of special interest after multiple large cardiovascular disease (CVD) outcomes studies have demonstrated superiority of these agents compared to placebo for major adverse CVD events and in some cases, hospitalization for heart failure. Despite the dramatic results of these trials, only recently have we began to understand the mechanisms underlying these CVD benefits. Here we review the underlying mechanisms which have the greatest plausibility for both of these agents including the impact of ventricular loading conditions, direct effects on cardiac structure and function, myocardial energetics and sodium/hydrogen exchange for SGLT2 inhibitors, and the anti-atherosclerotic, anti-inflammatory, and modulation of endothelial function for GLP-1 agonists.

中文翻译:

关于 SGLT2 抑制剂和 GLP1 激动剂药物对糖尿病心血管疾病作用的机制见解。

在过去十年中,随着多种抗高血糖药物的出现,心血管疾病和 2 型糖尿病已确诊或高危患者的治疗前景发生了翻天覆地的变化。钠-葡萄糖协同转运蛋白 2 (SGLT2) 抑制剂和胰高血糖素样肽-1 (GLP-1) 激动剂是两种抗高血糖药物类别,在多项大型心血管疾病 (CVD) 结果研究证明这些药物的优越性后,它们受到了特别的关注与安慰剂相比,主要不良心血管事件以及在某些情况下因心力衰竭住院。尽管这些试验取得了显着的结果,但直到最近我们才开始了解这些 CVD 益处的潜在机制。
更新日期:2019-08-02
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