The benefits of GLP1 receptors in cardiovascular diseases

L. Ferhatbegović, Denis Mršić, Amra Macić-Džanković
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Abstract

Glucagon like peptide-1 (GLP-1) receptor agonists are well established drugs for the treatment of type 2 diabetes (T2D). In addition to glycemic control, GLP-1 receptor agonists have beneficial other effects. They act by binding to GLP-1 receptors, which are widely distributed in the body, including cardiomyocytes and blood vessels. The aim of this article is to provide a comprehensive review of GLP-1 receptor agonists impact on cardiovascular outcomes and risk reduction. In the last decade, several cardiovascular outcomes trials (CVOT) have been conducted in order to explore cardiovascular benefit of GLP-1 receptor agonists. CVOTs primarily proved cardiovascular safety and tolerability of different GLP-1 receptor agonists, but also showed cardiovascular benefit of specific drugs. CVOTs have shown that GLP-1 receptor agonists reduce MACE in patients with T2D compared to placebo. In addition, they have positive impact on several cardiovascular risk factors such as obesity by promoting weight loss, blood pressure and blood lipid levels. Also, they stimulate the endothelium to produce nitric oxide, reduce oxidative stress, and have antiatherogenic and antiinflammatory effects. Studies have shown their positive impact on kidney outcomes in patients with T2D compared to placebo. The results of previous trials are encouraging in terms of multiple positive effects of GLP-1 receptor agonists. However, further research is needed to understand their full potential and all details of their mechanism of action, which will enable to expand the therapeutic indications and to determine their optimal use in clinical practice.
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GLP1 受体对心血管疾病的益处
胰高血糖素样肽-1 (GLP-1)受体激动剂是治疗2型糖尿病(T2D)的公认药物。除了血糖控制,GLP-1受体激动剂还有其他有益的作用。它们通过与GLP-1受体结合而起作用,GLP-1受体广泛分布在体内,包括心肌细胞和血管。本文的目的是提供GLP-1受体激动剂对心血管结局和风险降低的影响的全面综述。在过去的十年中,为了探索GLP-1受体激动剂对心血管的益处,已经进行了几项心血管结局试验(CVOT)。CVOTs主要证明了不同GLP-1受体激动剂的心血管安全性和耐受性,但也显示了特定药物的心血管益处。CVOTs显示,与安慰剂相比,GLP-1受体激动剂可降低T2D患者的MACE。此外,它们通过促进体重减轻、血压和血脂水平,对肥胖等几种心血管风险因素有积极影响。此外,它们刺激内皮细胞产生一氧化氮,减少氧化应激,并具有抗动脉粥样硬化和抗炎作用。研究表明,与安慰剂相比,它们对T2D患者肾脏预后有积极影响。在GLP-1受体激动剂的多重积极作用方面,先前的试验结果令人鼓舞。然而,需要进一步的研究来了解它们的全部潜力和作用机制的所有细节,这将有助于扩大治疗适应症并确定它们在临床实践中的最佳使用。
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