Sodium glucose cotransporter 2 inhibitors: mechanisms of action in heart failure
- PDF / 1,792,048 Bytes
- 20 Pages / 595.276 x 790.866 pts Page_size
- 41 Downloads / 186 Views
Sodium glucose cotransporter 2 inhibitors: mechanisms of action in heart failure Mieczysław Dutka1 · Rafał Bobiński1 · Izabela Ulman‑Włodarz1 · Maciej Hajduga1 · Jan Bujok1 · Celina Pająk1 · Michał Ćwiertnia2 Accepted: 12 October 2020 © The Author(s) 2020
Abstract Diabetes is a key independent risk factor in the development of heart failure (HF) and a strong, adverse prognostic factor in HF patients. HF remains the primary cause of hospitalisation for diabetics and, as previous studies have shown, when HF occurs in these patients, intensive glycaemic control does not directly improve the prognosis. Recent clinical studies assessing a new class of antidiabetic drugs, sodium-glucose cotransporter 2 inhibitors (SGLT2is) showed some unexpected beneficial results. Patients treated with SGLT2is had a significant decrease in both cardiovascular (CV) and all-cause mortality and less hospitalisations due to HF compared to those given a placebo. These significant clinical benefits occurred quickly after the drugs were administered and were not solely due to improved glycaemic control. These groundbreaking clinical trials’ results have already changed clinical practice in the management of patients with diabetes at high CV risk. These trials have triggered numerous experimental studies aimed at explaining the mechanisms of action of this unique group of drugs. This article presents the current state of knowledge about the mechanisms of action of SGLT2is developed for the treatment of diabetes and which, thanks to their cardioprotective effects, may, in the future, become a treatment for patients with HF. Keywords Heart failure · Cardiovascular diseases · Diabetes · Sodium-glucose cotransporter 2 inhibitors
Introduction A new group of antidiabetic drugs, sodium-glucose cotransporter 2 inhibitors (SGLT2is), has recently been shown to significantly improve the prognosis in high-risk cardiovascular (CV) patients with type 2 diabetes. The CV outcomes of SGLT2is (empagliflozin, canagliflozin and dapagliflozin) have been evaluated in, among others, three randomised clinical trials: Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPAREG OUTCOME), Canagliflozin Cardiovascular Assessment Study (CANVAS) and Dapagliflizin Effect on Cardiovascular Events Thrombosis in Myocardial Infarction 58 * Mieczysław Dutka [email protected] 1
Faculty of Health Sciences, Department of Biochemistry and Molecular Biology, University of Bielsko-Biała, Willowa St. 2, 43‑309 Bielsko‑Biała, Poland
Faculty of Health Sciences, Department of Emergency Medicine, University of Bielsko-Biała, Willowa St. 2, 43‑309 Bielsko‑Biała, Poland
2
(DECLARE—TIMI 58) [1–10]. The first and thus groundbreaking EMPA-REG OUTCOME study showed that the use of empagliflozin in patients with type 2 diabetes and a high CV risk reduced CV mortality by 38%, without significantly reducing the number of non-fatal myocardial infarctions and strokes [11, 12]. The use of empagliflozin in this group of patients also result
Data Loading...
