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Exploration of the clinical benefits of sodium glucose co-transporter 2 inhibitors in diabetic patients with concomitant heart failure

机译：糖尿病患者合并心力衰竭的钠糖共转运蛋白2抑制剂的临床意义探讨

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Prevention and treatment strategies for heart failure (HF) in diabetes have not been fully established, at least partly due to lack of recognition of a pathological link between the two and effective antidiabetic agents for HF. Recent cardiovascular (CV) outcomes trials demonstrated that treatment with sodium glucose co-transporter 2 (SGLT2) inhibitors greatly improved major CV adverse events in type 2 diabetes (T2D) patients at high risk for CV events, seemingly driven by risk reduction in HF-related outcomes. The beneficial effects of SGLT2 inhibitors on such outcomes and the heart itself are unique characteristics among antidiabetic agents, and SGLT2 inhibitors are expected to be a promising therapeutic option for CV disease and HF care. However, because a limited number of T2D patients with concomitant HF were included in the CV outcomes trials, the treatment effects of SGLT2 inhibitors for such conditions have not been fully investigated. Moreover, there has been little evidence to suggest SGLT2 inhibitor mediated effects on CV function and relevant biomarkers. Januzzi et al. (J Am Coll Cardiol 70: 704–712, ) reported that canagliflozin treatment could delay the escalation of cardiac biomarkers in older T2D patients, suggesting direct CV protection by SGLT2 inhibitors in this population. Whether SGLT2 inhibitors can exert similar benefits in T2D patients with concomitant HF will likely be the next big issue of medical concern. Furthermore, newer clinical trials are currently ongoing to investigate whether SGLT2 inhibitors exhibit beneficial effects for HF, both in the presence and absence of T2D. Such trials may potentially identify novel approaches for treating HF.
机译：糖尿病心力衰竭（HF）的预防和治疗策略尚未完全建立，至少部分原因是由于缺乏对这两种有效的抗糖尿病药之间的病理联系的认识。最近的心血管（CV）结果试验表明，使用钠葡萄糖共转运蛋白2（SGLT2）抑制剂治疗可大大改善2型糖尿病（T2D）高心血管事件风险的主要心血管不良事件，这似乎是由HF-相关结果。 SGLT2抑制剂对此类结局和心脏本身的有益作用是抗糖尿病药的独特特征，并且SGLT2抑制剂有望成为CV疾病和HF护理的有前途的治疗选择。但是，由于CV结果试验中包括了数量有限的伴有HF的T2D患者，因此尚未充分研究SGLT2抑制剂在此类情况下的治疗效果。而且，几乎没有证据表明SGLT2抑制剂介导了对CV功能和相关生物标志物的作用。 Januzzi等。 （J Am Coll Cardiol 70：704–712，）报道，Canagliflozin治疗可能会延缓老年T2D患者心脏生物标志物的升高，提示该人群中SGLT2抑制剂可直接保护心血管。 SGLT2抑制剂是否可以在伴发HF的T2D患者中发挥相似的益处，将成为医学关注的下一个大问题。此外，目前正在进行新的临床试验，以研究SGLT2抑制剂在有无T2D的情况下是否对HF表现出有益作用。这样的试验可能会发现治疗HF的新方法。

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