Effects of sodium-glucose cotransporter-2 inhibitors on the cardiovascular and renal complications of type 2 diabetes.

摘要: Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) have been shown to mitigate the risks of cardiovascular (CV) and renal complications in patients with type 2 diabetes (T2D) CV risk factors or disease (CVD). In outcomes trials (CVOTs) T2D established CVD multiple factors, empagliflozin canagliflozin were associated significant reductions major adverse events (MACE), hospitalization for heart failure (HF) kidney progression. DECLARE-TIMI 58 study, which majority did not CVD, dapagliflozin was composite end point death HF noninferior placebo regard MACE; although had relatively good function, also showed benefits similar those seen canagliflozin. This article reviews increased discusses potential mechanisms cardioprotective renoprotective effects SGLT-2i therapy. The observed improvements SGLT-2is CVOTs suggest a class effect this patient population influenced treatment guidelines way add-on therapy metformin is initiated high risk. overall are most likely attributable mechanisms, including cardiac, haemodynamic, metabolic, anti-inflammatory effects.