目錄/各期文章

內科學誌 -第32卷第4期

專題 
Impact on Cardiovascular Disease of Sodium–Glucose Cotransporter-2 Inhibitors for the Treatment of Type 2 Diabetes  全文閱讀
242~256 
英文 
Sodium–glucose cotransport-2 inhibitor、 Type 2 diabetes、Cardiovascular disease、Cardioprotection、Heart failure 
Kuo-Bin Tseng1  
E-DA Cancer Hospital/I-Shou University, Kaohsiung, Taiwan1  
       Type 2 diabetes (T2D) has a close link with cardiovascular disease (CVD), which remains the major cause of mortality in the diabetic population worldwide. Sodium–glucose cotransporter-2 inhibitors (SGLT2i) are novel antidiabetic drugs that act by blocking sodium–glucose cotransporter-2 in the renal proximal tubules to inhibit glucose reabsorption and therefore lower blood sugar. SGLT2i have beneficial effects on blood pressure, body weight, albuminuria, uric acid, proinflammatory mediators, and adipokines. Notably, SGLT2i have shown impressive cardioprotection through effects on cardiac fuel energetics, ventricular loading, sodiumhydrogen exchangers, left ventricular remodeling, and cardiomyocyte fibrosis and apoptosis. On the basis of recent large-scale cardiovascular outcome trials (CVOTs) in patients with T2D and established CVD or at high risk of cardiovascular events, SGLT2i protected against cardiovascular mortality and all-cause mortality. Furthermore, SGLT2i lowered the rate of hospitalization for heart failure and progressive kidney disease irrespective of pre-existing CVD or history of heart failure. Dedicated CVOTs have provided a strong evidence of the role of SGLT2i in preventing or slowing the progression of CVD in patients with T2D. This review synthesizes the most cutting-edge insights into the cardioprotective benefits of SGLT2i in individuals with T2D.   (J Intern Med Taiwan 2021; 32: 242-256)