Off-target Effects of Sodium-glucose Cotransporter 2 (SGLT-2) Inhibitor in Cardiovascular Disease

摘要

The newest class of diabetes medicines, the sodium-glucose cotransporter-2 (SGLT-2) inhibitors, are transforming medical therapy for diabetes patients with cardiovascular disease (CVD). Several cardiovascular outcome trials (CVOTs) have shown that SGLT-2 inhibitors produce effects beyond glucose lowering and have demonstrated beneficial cardiovascular and renal effects that have been observed across a broad range of patients with type 2 diabetes mellitus (T2DM). Recently, Food and Drug Administration expanded the indications for SGLT-2 inhibitors for T2DM patients who have either established CVD or are at risk of developing CVD. Furthermore, new clinical trials have been launched to expand the use of their SGLT-2 inhibitors in patients with chronic heart failure. Interestingly, the Dapagliflozin and Prevention of Adverse-Outcomes in Heart Faiure (DAPA-HF) Trial showed clinical benefit in heart failure with and without T2DM, which support the idea that SGLT-2 inhibitor may be beneficial to patients beyond diabetes.