Medicina, Год журнала: 2024, Номер 60(12), С. 1986 - 1986
Опубликована: Дек. 2, 2024
The increasing prevalence of both type 2 diabetes mellitus and heart failure has underscored the urgent need for optimized therapeutic strategies that address complex interplay between these conditions. Dipeptidyl peptidase-4 (DPP-4) inhibitors have emerged as a popular class glucose-lowering agents due to their favorable glycemic effects, safety profile, potential cardiovascular benefits. However, impact DPP-4 on outcomes in patients with remains contentious, conflicting evidence from clinical trials observational studies. This review critically examines current use coexisting failure, focusing pharmacodynamics, safety, efficacy outcomes. We explore physiological mechanisms by which may influence risk, including modulation inflammation, oxidative stress, myocardial fibrosis. Clinical such SAVOR-TIMI 53, EXAMINE, TECOS are evaluated provide comprehensive analysis inhibitors' effects hospitalization mortality, events diabetic patients. While some suggest an increased risk HF hospitalizations specific (e.g., saxagliptin), others report neutral raising questions about versus individual drug characteristics within this group. Additionally, we discrepancies related patient demographics, phenotype, comorbid conditions risk-benefit profile. Comparative insights into alternative therapies SGLT2 GLP-1 receptor agonists also provided, highlighting implications treatment selection high-risk population. In summary, synthesizes available aiming guide clinicians making informed decisions. remain viable option management, caution is warranted advanced future research essential refine patient-specific guidelines.
Язык: Английский