Kalp yetersizliği tedavisinde sodyum glikoz ko-transporter 2 inhibitörleri
Küçük Resim Yok
Tarih
2020
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Sodyum glikoz ko-transporter-2 inhibitörleri (SGLT-2i), glükoz geri emiliminin sağlandığı böbrek proksimal tübüllerinde glikoz reabsorbsiyonunu engelleyip glükozuri, diürez ve natriüreze neden olarak etkili olan yeni antidiyabetik ajanlardır. Geniş çaplı randomize klinik çalışmalarda, aterosklerotik kardiyovasküler (KV) hastalığı veya yüksek KV risk faktörleri olan tip 2 diyabette (T2DM), majör KV olayları ve kalp yetersizliğine (KY) bağlı hastane yatışlarını azalttığı ortaya konmuştur. Bu çalışmalarda en büyük ve tutarlı etkinin KY nedenli hastane yatışlarını azaltması üzerine olduğu gözlenmiştir. KY nedenli hastane yatışlarına etkisinin KY tanısı bulunan hasta subgruplarında da gösterilmiş olması SGLT2i’lerin T2DM olsun olmasın tüm KY olgularında klinik yararlar sağlayabileceği düşüncesini ortaya koymuştur. Yeni yayınlanan DAPA-HF çalışmasında, standart KY tedavisi üzerine eklenen ve SGLT-2i olan dapagliflozinin diyabet olsun olmasın KY bulunan olgularda KY nedenli hastane yatışlarını, KV mortalite ve tüm nedenli mortaliteyi azalttığı, yaşam kalitesini düzelttiği gösterilmiştir. Bu sonuçlar SGLT2i’lerin KY’de etkin bir tedavi seçeneği olma potansiyeline sahip olduğunu desteklemektedir. Bu derlemede SGLT2i’lerin KY tedavisindeki rolü değerlendirilmektedir.
Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are a new class of drugs for patients with type 2 diabetes (T2DM) which inhibit urinary glucose reabsorption in the proximal tubule of the nephron and result in glucosuria, natriuresis and diuresis. in large, randomized clinical trials, SGLT-2i have been shown to reduce major cardiovascular (CV) events and heart failure (HF) hospitalizations in patients with T2DM who have atherosclerotic CV disease or CV risk factors. in these trials, SGLT-2i is have their greatest and most consistent effect on reducing the risk of HF hospitalization. the reduction in HF hospitalization was also observed in subgroups of patients with a HF diagnosis at baseline, which raised the possibility of a clinical benefit of SGLT-2i in HF patients, regardless of the presence or absence of T2DM. in very recently published DAPA-HF trial, a SGLT-2i, dapagliflozin treatment on top of standard HF therapy has been shown to have clear clinical benefits in terms of reducing HF hospitalization, CV mortality, all-cause mortality and improving quality of life in HF patients. This compelling evidence suggests that SGLT-2i have a potential to be an effective treatment option in HF, regardless of diabetes. This article provides a comprehensive overview focused on the role of SGLT-2i in the treatment of HF.
Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are a new class of drugs for patients with type 2 diabetes (T2DM) which inhibit urinary glucose reabsorption in the proximal tubule of the nephron and result in glucosuria, natriuresis and diuresis. in large, randomized clinical trials, SGLT-2i have been shown to reduce major cardiovascular (CV) events and heart failure (HF) hospitalizations in patients with T2DM who have atherosclerotic CV disease or CV risk factors. in these trials, SGLT-2i is have their greatest and most consistent effect on reducing the risk of HF hospitalization. the reduction in HF hospitalization was also observed in subgroups of patients with a HF diagnosis at baseline, which raised the possibility of a clinical benefit of SGLT-2i in HF patients, regardless of the presence or absence of T2DM. in very recently published DAPA-HF trial, a SGLT-2i, dapagliflozin treatment on top of standard HF therapy has been shown to have clear clinical benefits in terms of reducing HF hospitalization, CV mortality, all-cause mortality and improving quality of life in HF patients. This compelling evidence suggests that SGLT-2i have a potential to be an effective treatment option in HF, regardless of diabetes. This article provides a comprehensive overview focused on the role of SGLT-2i in the treatment of HF.
Açıklama
Anahtar Kelimeler
0-Belirlenecek
Kaynak
Türk Kardiyoloji Derneği Arşivi
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N/A
Scopus Q Değeri
Cilt
48
Sayı
3
