Therapeutic Potential of Sodium-glucose Co-transporter-2 Inhibitors and Glucagon-like Peptide-1 Receptor Agonists for Patients with Acute Coronary Syndrome: A Review of Clinical Evidence

Current Pharmaceutical Design, Journal Year: 2024, Volume and Issue: 30(27), P. 2109 - 2119

Published: June 24, 2024

Atherosclerotic Cardiovascular Disease (ASCVD) is still one of the leading causes death globally, with Coronary Artery (CAD) being most prevalent form ASCVD. Patients type 2 Diabetes Mellitus (DM) experience an increased risk for ASCVD during disease course, CAD common cause among affected individuals, resulting in shorter life expectancy and morbidity survivors. Recently, novel classes anti-diabetic drugs, namely Sodium-Glucose Co-Transporter- (SGLT-2) inhibitors Glucagon-Like Peptide-1 (GLP-1) receptor agonists, have shown impressive cardio-renal benefits patients DM, while they might decrease even absence baseline DM. However, there no evidence to date regarding their safety efficacy setting acute coronary syndrome (ACS) event, regardless concomitant This study aims provide a detailed, updated presentation currently available clinical concerning potential role SGLT-2 GLP-1 agonists ACS, highlight whether those drug could be utilized as adjuncts standard-of-care treatment this specific patient population, along short- long-term cardiovascular benefits.

Language: Английский

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Oxidative Stress and Its Biomarkers in Cardiovascular Diseases

Artery Research, Journal Year: 2024, Volume and Issue: 30(1)

Published: Oct. 29, 2024

Abstract Background Cardiovascular diseases (CVDs) are the most common cause of death worldwide. CVDs share heterogeneous pathophysiologic mechanisms, one which includes increased oxidative stress. Main Body Surplus levels reactive oxygen species induce damage to cellular macromolecules such as DNA, proteins, and lipids. Increased result in decreased nitric oxide availability, vasoconstriction, development procoagulant proinflammatory states blood vessels. Conclusion Improved knowledge biomolecular processes triggered by stress has helped develop tools for assessing markers applying them clinical settings. Nevertheless, some research gaps should be filled, specifically defining clinically relevant biomarkers with high sensitivity specificity CVD.

Language: Английский

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Update on Obesity and Cardiovascular Risk: From Pathophysiology to Clinical Management

Nutrients, Journal Year: 2024, Volume and Issue: 16(16), P. 2781 - 2781

Published: Aug. 20, 2024

Obesity is an epidemic worldwide. Overweight and multiple obesity-related mechanisms, including dysmetabolic alterations, contribute to cardiovascular deleterious effects. Hence, overweight obesity have been independently associated with increased risk, whose assessment crucial for preserving life quality reducing mortality, address appropriate therapeutic strategies in obese patients. Beyond the standard of care managing adults (i.e., diet physical exercise), several relevant pharmacotherapies approved, procedures device types weight loss recommended. In such a contest, medical management remains one option treating excess weight. Most drugs used reduce appetite increase satiety and, secondarily, slow gastric emptying body therefore, act also improve metabolic parameters. this agonists glucagon-like peptide-1 receptor (GLP-1RAs) modulate different pathways glucose metabolism, energy homeostasis, antioxidation, inflammation. Moreover, class has shown efficacy improving glycemic control, incidence events type 2 diabetic patients, presence diabetes. Recently, or patients pre-existing disease but without diabetes, GLP-1RA semaglutide reduced cerebrovascular death from causes. Thus, approved secondary prevention people disease. Nevertheless, whether equally effective primary be demonstrated. review, we will summarize updates on pathophysiology obesity, effects impact phenotypes diseases, novelties clinical prevention.

Language: Английский

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Causal relationships between GLP1 receptor agonists, blood lipids, and heart failure: a drug-target mendelian randomization and mediation analysis

Diabetology & Metabolic Syndrome, Journal Year: 2024, Volume and Issue: 16(1)

Published: Aug. 29, 2024

Glucagon-like peptide-1 receptor (GLP1R) agonists have been shown to reduce major cardiovascular events in diabetic patients, but their role heart failure (HF) remains controversial. Recent evidence implies potential benefits on cardiometabolism such as lipid metabolism, which may contribute lowering the risk of HF. Consequently, we designed a Mendelian randomization (MR) study investigate causal relationships circulating lipids mediating GLP1R

Language: Английский

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The protective effects of liraglutide in reducing lipid droplets accumulation and myocardial fibrosis in diabetic cardiomyopathy

Cellular and Molecular Life Sciences, Journal Year: 2025, Volume and Issue: 82(1)

Published: Jan. 8, 2025

Diabetes is a primary contributor to diabetic cardiomyopathy (DbCM), which marked by metabolic imbalances such as elevated blood glucose and lipid levels, leading significant structural functional alterations in the myocardium. Elevated free fatty acids (FFAs) hyperglycemia play critical roles DbCM development, with FFAs inducing insulin resistance cardiomyocytes promoting accumulation, resulting oxidative stress fibrosis. Current research suggests that glucagon-like peptide-1 (GLP-1) receptor agonists may effectively mitigate DbCM, although an effective treatment for this condition remains elusive, precise mechanisms of protective effect are not fully understood. In study, we aimed replicate glucolipotoxic conditions treating differentiated H9c2 cells high acids. Additionally, model was induced mice through high-fat diets. Both vitro vivo models were used investigate effects liraglutide on elucidate its underlying molecular mechanisms. Our findings indicate significantly reduces droplet (LD) formation myocardial fibrosis, evidenced decreased expression fibrosis markers, including TGF-β1 collagen types I III. Liraglutide also enhanced AMP-activated protein kinase (AMPK) activation, improved mitochondrial function, increased antioxidant gene expression, signaling, reduced stress. These results demonstrate potential therapeutic role managing diabetes-related cardiac complications, offering comprehensive approach improving outcomes patients diabetes.

Language: Английский

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GLP-1 receptor agonists—another promising therapy for Alport syndrome?

Journal of Rare Diseases, Journal Year: 2025, Volume and Issue: 4(1)

Published: Feb. 28, 2025

Abstract Alport syndrome (AS) is a progressive monogenic glomerular kidney disease characterised by function decline, hearing loss, and ocular abnormalities, often leading to early-onset failure (KF). While current therapies, such as renin-angiotensin system inhibitors (RASi), offer some benefits, many patients still experience KF at young age, highlighting the need for additional treatment options. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged promising agents with demonstrated cardiovascular nephroprotective effects in type 2 diabetes (T2D) chronic (CKD) patients. Evidence from several major clinical trials has shown that GLP-1 RAs can reduce events slow CKD progression reducing albuminuria. Their potential mechanisms of action include anti-inflammatory, anti-fibrotic, antioxidative effects, making them particularly relevant AS, where inflammation fibrosis play crucial roles progression. This review explores therapeutic summarising pre-clinical data elucidating pathways through which might renoprotective benefits. We advocate further research into their application AS recommend inclusion future better understand impact on patient outcomes.

Language: Английский

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Weekly Journal Scan: Effects of oral semaglutide on cardiovascular outcomes in patients with type 2 diabetes and high risk profile

European Heart Journal, Journal Year: 2025, Volume and Issue: unknown

Published: April 29, 2025

Language: Английский

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Exploring the Multi-Faceted Effects of Berberine in Ameliorating Diastolic Dysfunction in Rats with Heart Failure with Preserved Ejection Fraction

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(10), P. 4847 - 4847

Published: May 19, 2025

Heart failure with preserved ejection fraction (HFpEF), marked by cardiac diastolic dysfunction, contributes to half of all heart cases globally and poses a significant public health challenge. Effective therapies for HFpEF are rare, largely due its complex heterogeneous pathophysiology, which often involves multiple comorbidities. Berberine (BBR), an isoquinoline alkaloid, has demonstrated beneficial effects on metabolic cardiovascular disorders; however, impact dysfunction in remains poorly understood. In this study, we utilized rat model induced sustained high-fat/high-sucrose (HFHS) diet explore the mechanisms BBR dysfunction. The results revealed that administration effectively alleviated extracardiac comorbidities, including increased weight, impaired glucose tolerance, hypercholesterolemia hypertension, rats fed HFHS diet. Furthermore, mitigated myocardial inflammation, oxidative stress, microvascular endothelial notably restored disturbed NO-cGMP-PKG pathway. Additionally, reduced fibrosis inhibited abnormally activated TGF-β/Smads signaling. Moreover, attenuated systemic inflammation corrected immune dysregulation diet-fed rats. Our study suggests exhibits multi-beneficial prevention management HFpEF, demonstrating potential as holistic therapeutic candidate HFpEF.

Language: Английский

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Cardioprotective effects of glucagon-like peptide 1 receptor agonists in heart failure: Myth or truth?

World Journal of Diabetes, Journal Year: 2024, Volume and Issue: 15(5), P. 818 - 822

Published: May 10, 2024

Therapy with glucagon-like peptide 1 (GLP1) receptor agonists has raised great interest for its beneficial cardiovascular effects in preventing atherosclerosis and heart failure-related outcomes. However, while evidence about consistently suggests a cardioprotective potential class effect, controversies remain on impact failure. GLP1 appear to prevent hospitalization new-onset failure reduce symptoms preserved ejection fraction (as demonstrated by the recent STEP-HFpEF Trial). Still, agonism resulted neutral or even harmful patients established reduced (the LIVE trial). benefit system indirectly through their marked metabolic (improved weight management, glycemic control, blood pressure, systemic tissue inflammation), direct have been questioned. Nonetheless, loss alone achieved failed improving left ventricular functions. Tirzepatide is dual agonist of glucose-dependent insulinotropic polypeptide, representing an innovative treatment option diabetes major promising benefits. Whether this therapies going change history ongoing debate.

Language: Английский

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Cardiometabolic Crossroads: Obesity, Sleep-Disordered Breathing, and Epicardial Adipose Tissue in Heart Failure with Preserved Ejection Fraction – A Mini-Review

Heart and Mind, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 11, 2024

Abstarct Obesity, a multifaceted metabolic disorder, stands out as significant risk factor in the development of heart failure with preserved ejection fraction (HFpEF). Its involvement HFpEF pathogenesis encompasses complex interplay adipose tissue, particularly epicardial tissue (EAT), and effects sleep-disordered breathing (SDB). Understanding these intricate relationships is pivotal for devising targeted therapeutic approaches to alleviate burden individuals obesity. EAT assumes central role linking obesity HFpEF. As it expands context obesity, contributes systemic inflammation insulin resistance, fostering an environment conducive cardiac remodeling dysfunction. Furthermore, SDB, prevalent comorbidity obese population, emerges mediator through various mechanisms. The convergence expansion, SDB creates synergistic effect, heightening development. On pharmaceutical front, ongoing investigations explore novel strategies targeting inflammation, oxidative stress, pathways associated These include potential roles sodium-glucose cotransporter 2 inhibitors glucagon-like peptide-1 receptor agonists, offering innovative avenues managing In addition, lifestyle modifications such weight management interventions addressing reduction emerge promising preventing population. hold mitigate obesity-related risks improve outcomes.

Language: Английский

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