Sodium-glucose cotransporter 2 inhibitors and atherosclerosis

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have emerged as a promising therapeutic class in cardiovascular disease. This review synthesizes clinical and preclinical evidence on their effects on atherosclerosis, arterial stiffness and related conditions, including dyslipidemia, coronary artery disease, peripheral artery disease, and stroke. The atheroprotective advantages of SGLT2i are attributed to multiple mechanisms, including modulation of inflammatory pathways, improvements in vascular function, and reductions in oxidative stress, in addition to enhanced glycemic control, weight reduction, antihypertensive, and antifibrotic effects. Recent studies highlight their minimal adverse effects and compatibility for combination therapies, further expanding their clinical applications. SGLT2i have redefined the landscape of cardiovascular treatment through their extensive range of benefits, offering significant promise in optimizing outcomes for patients with atherosclerotic cardiovascular disease. By setting new standards of care and maintaining a favorable safety profile, these agents continue to advance the paradigm of cardiovascular disease management. While definitive conclusions require further investigation, SGLT2i have become serious contenders in the argument for antiatherosclerotic effects, with accumulating evidence suggesting their positive influence.