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首页> 外文期刊>The American Journal of Cardiology >Cardiovascular Effects of Noeinsulin, Glucose-Lowering Agents:Need for More Outcomes Data
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Cardiovascular Effects of Noeinsulin, Glucose-Lowering Agents:Need for More Outcomes Data

机译：Noeinsulin，降糖药的心血管作用：需要更多结果数据

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Macro vascular complications of type 2 diabetes mellitus (DM) are primarily driven by the combination of underlying atherosclerosis and propensity for thrombosis. Prevention of macrovascular complications in DM relies on therapies directed at multiple coexisting intermediary pathophysiologies that contribute to cardiovascular events, including hyperglycemia, lipoprotein abnormalities, hypertension, inflammation, and propensity for thrombosis. Multiple noninsulin, glucose-lowering agents have been developed that effectively lower blood glucose levels. This review explores the literature on the cardiovascular benefits and harms associated with these therapies, with an emphasis on cardiovascular outcomes when available. The lack of long-term data on cardiovascular outcomes regarding safety and efficacy of available traditional glucose-lowering agents has led to recommendations for more thorough evaluations of new therapies before approval. Furthermore, recent data suggest harm from intensive hemoglobin A_(lc )reductions. Accordingly, there are multiple, large, cardiovascular-event driven phase 3-4 trials of therapies from the incretin axis currently enrolling. Recommendations for a therapeutic approach with noninsulin, glucose-lowering agents for the prevention of cardiovascular events in patients with type 2 DM are provided based on current data. Ultimately, multifactorial risk interventions, including lifestyle modifications, antihyperglycemic agents, antihyper-tensives, statins, and aspirin remain the primary focus to prevent macrovascular complications in patients with type 2 DM.
机译：2型糖尿病（DM）的大血管并发症主要由潜在的动脉粥样硬化和血栓形成的倾向共同驱动。 DM中大血管并发症的预防依赖于针对多种共存的中间病理生理学的疗法，这些病理生理学有助于心血管事件，包括高血糖，脂蛋白异常，高血压，炎症和血栓形成倾向。已开发出多种可有效降低血糖水平的非胰岛素降糖药。这篇综述探讨了与这些疗法相关的心血管益处和危害的文献，并着重于可获得的心血管结果。缺乏有关可用的传统降糖药的安全性和有效性的心血管结果的长期数据，导致建议在批准前对新疗法进行更彻底的评估。此外，最近的数据表明，强烈的血红蛋白A_（lc）降低会造成伤害。因此，目前有许多关于肠降血糖素的疗法有多个大型的，由心血管事件驱动的3-4期临床试验。根据当前数据，提供了使用非胰岛素，降糖药预防2型DM患者心血管事件的治疗方法的建议。最终，包括生活方式改变，降糖药，降压药，他汀类药物和阿司匹林在内的多因素风险干预仍然是预防2型DM患者大血管并发症的主要重点。

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