Cardiorenal mechanisms of action of glucagon-like-peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors.
chronic kidney disease
diabetes
heart failure
myocardial infarction
obesity
stroke
Journal
Med (New York, N.Y.)
ISSN: 2666-6340
Titre abrégé: Med
Pays: United States
ID NLM: 101769215
Informations de publication
Date de publication:
12 11 2021
12 11 2021
Historique:
received:
15
07
2021
revised:
14
09
2021
accepted:
05
10
2021
entrez:
19
5
2022
pubmed:
20
5
2022
medline:
24
5
2022
Statut:
ppublish
Résumé
Cardiovascular and renal outcome trials (CVOTs) for glucagon-like-peptide-1 receptor agonists (GLP1RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) highlight new options for people with and without type 2 diabetes (T2D). Drugs within these classes reduce rates of major adverse cardiovascular events (MACE), with SGLT2i simultaneously attenuating decline in kidney function. SGLT2i reduce rates of heart failure in people with and without T2D, whereas GLP1RA lower rates of myocardial infarction and stroke in people with T2D with or without preexisting cardiovascular disease. Mechanistically, SGLT2 and the GLP-1 receptor are expressed at low levels in the heart, and within some blood vessels and immune cells, implying indirect mechanisms of action for the preservation of ventricular function, and reduction of atherosclerosis. SGLT2i likely preserve renal function through the alteration of glomerular hemodynamics. These two drug classes enable organ protection and reduced mortality in people with T2D and represent promising therapies for some people without T2D.
Identifiants
pubmed: 35590197
pii: S2666-6340(21)00344-5
doi: 10.1016/j.medj.2021.10.004
pii:
doi:
Substances chimiques
Glucagon-Like Peptide-1 Receptor
0
Sodium-Glucose Transporter 2 Inhibitors
0
Glucagon
9007-92-5
Sodium
9NEZ333N27
Glucose
IY9XDZ35W2
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1203-1230Subventions
Organisme : CIHR
ID : 154321
Pays : Canada
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of interests D.J.D. has served as a consultant or speaker for Eli Lilly, Forkhead, Kallyope, Merck, Novo Nordisk, and Pfizer. Basic science studies in the Drucker lab are supported in part by grants from Novo Nordisk and Pfizer. DJD holds non-exercised stock options in Kallyope. D.Z.I.C. has received consulting fees, speaking honoraria, or both, from Bristol-Myers Squibb, Novo Nordisk, Mitsubishis-Tanabe, MAZE, Janssen, Bayer, Boehringer Ingelheim-Eli Lilly, AstraZeneca, Merck, Prometic, and Sanofi, and has received operating funds from Janssen, Boehringer Ingelheim-Eli Lilly, Sanofi, AstraZeneca, Novo Nordisk, and Merck. J.A.U. has served as a consultant or speaker for AstraZeneca, Bayer, Boehringer Ingelheim-Lilly, Janssen, Merck, Novartis, and Sanofi and receives research grants to his institution from Amgen, Bayer, Boehringer Ingelheim-Lilly, and Janssen.