JACC:降糖药物与心血管关系十大认识:二甲双胍可能是**对心血管有益的降糖药物

2017-06-01 钟巧青 张国刚 中国循环杂志

近日,JACC发表文章强调了降糖药物对心血管系统的影响作用,以下是该文的十大要点。

近日,JACC发表文章强调了降糖药物对心血管系统的影响作用,以下是该文的十大要点。



1 FDA以及欧洲药品管理局强制推行了一项制度,即所有新型降糖药物必须有前瞻、随机、对照的临床试验证明其心血管安全性。

2 基于一些临床终点事件的研究,部分磺脲类药物已经因为增加心血管事件风险而被FDA黑框警告。

3 迄今为止,只有二甲双胍是唯一可能有心血管获益的降糖药物。

4 二甲双胍不会引起体重增加,也不增加低血糖的风险,有多年使用安全的证据,且价格低廉,适合作为首选并可广泛应用于糖尿病合并有心血管疾病患者。

5 近期有部分研究表明,有些治疗2型糖尿病的新药能降低合并心血管疾病的糖尿病患者的心血管事件。

6 SGLT2抑制剂empagliflozin能显着和迅速减少心血管死亡和心衰患者的入院率,这可能与该药能改善血流动力学以及改善代谢机能有关。

7 GLP-1受体拮抗剂liraglutide和 semaglutide也能降低心血管死亡风险,极大地减少心血管事件,但显效较慢且未能降低心衰的风险。

8 心血管病学专家应熟悉降糖药物的心血管获益,因为很多2型糖尿病的患者合并有心血管疾病,而这些患者更应该从治疗中获益。

9 心血管病学专家也应该在心血管疾病患者中广泛筛查2型糖尿病的患者,界定这些目标人群,让这些患者尽早的从上述治疗中获益。

10 与其他心脏疾病的防治团队一样,心血管病学专家、全科医生以及糖尿病学专家应该共同协作,以期给予心血管病易患2型糖尿病的人群更为优化的治疗方案。

原始出处:

Naveed Sattar, Mark C. Petrie, et al. Novel Diabetes Drugs and the Cardiovascular Specialist. Journal of the American College of Cardiology.Volume 69, Issue 21, May 2017 DOI: 10.1016/j.jacc.2017.04.014

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    2017-06-26 hbwxf
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    2017-06-03 Medsci0421

    目前达格列净将在国内上市,但有明确心血管获益的是恩格列净

    0

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    2017-06-03 1e21e196m68(暂无匿称)

    学习了

    0

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  7. 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encodeId=87e9205302ad, content=长知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKmBmKp701U36eJdr3ce0u5SggZ7BUKvXicI6GTwL7eTA1WOnc6zeNxMUYr0S6hAuhqZR7rbct0pwQ/0, createdBy=08de2068775, createdName=176****9265, createdTime=Thu Jun 01 17:40:18 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205300, encodeId=5db420530042, content=第7条写错了。liraglutide是GLP-1受体激动剂, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJXCR8W80NNgQuicJU3aIm3JtiaNAFLYSMlBuVfGkSlw5Z5VpmZK4PyiaDURLAorhvwhWVnaM1gQdJXA/132, createdBy=a01444383, createdName=lixh1719, createdTime=Thu Jun 01 17:31:18 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205248, encodeId=623120524885, content=学习了,涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Jun 01 13:42:15 CST 2017, time=2017-06-01, status=1, ipAttribution=)]
    2017-06-01 阿吴

    学习

    0

  8. 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    2017-06-01 176****9265

    长知识了

    0

  9. 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CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205248, encodeId=623120524885, content=学习了,涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Jun 01 13:42:15 CST 2017, time=2017-06-01, status=1, ipAttribution=)]
    2017-06-01 lixh1719

    第7条写错了。liraglutide是GLP-1受体激动剂

    0

  10. 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    2017-06-01 1ddf0692m34(暂无匿称)

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