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Agonistas del receptor GLP-1 para la reducción del riesgo cardiovascular aterosclerótico en pacientes con diabetes

Nikolaus Marx¹, Mansoor Husain^2,3, Michael Lehrke¹

¹Department of Internal Medicine I (Cardiology), University Hospital, Rheinisch-Westfälische Technische Hochschule Aachen University, Germany (N.M., M.L.).

|December 12, 2022

Resumen

Los agonistas de los receptores de péptido tipo glucagón-1 (ARGLP-1) reducen significativamente los eventos cardiovasculares en pacientes con diabetes tipo 2. A pesar de los beneficios comprobados, la absorción sigue siendo baja, lo que requiere una mejor aplicación en la práctica cardiológica.

Área de la Ciencia:

Cardiología
Endocrinología
Farmacología

Sus antecedentes:

La diabetes tipo 2 (DT2) conlleva un alto riesgo de enfermedad cardiovascular (ECV).
Los nuevos agentes reductores de glucosa, los inhibidores de SGLT2 (SGLT2i) y los agonistas de los receptores de GLP-1 (GLP-1 RA), han demostrado una reducción significativa del riesgo de ECV.
Las directrices ahora recomiendan estos agentes para pacientes de alto riesgo de DM2, independientemente del control glucémico.

Objetivo del estudio:

Para resumir la evidencia sobre la AR GLP-1 para la reducción del riesgo cardiovascular en la diabetes tipo 2.
Proporcionar orientación práctica para la aplicación de la AR GLP-1 en cardiología.

Principales métodos:

Revisión de los datos experimentales y clínicos de los ensayos de resultados cardiovasculares.
Análisis de los mecanismos de AR GLP-1, incluida la reducción de la glucosa, la inducción de la saciedad y la pérdida de peso.

Principales resultados:

La AR GLP-1 demuestra reducciones robustas en los eventos cardiovasculares adversos mayores y las hospitalizaciones por insuficiencia cardíaca.
Se observó una reducción consistente de los eventos atero- trombóticos, especialmente en pacientes con ECV aterosclerótica establecida.
A pesar de las sólidas evidencias, la utilización de la AR GLP- 1 por parte de los pacientes sigue siendo subóptima.

Conclusiones:

Los AR GLP-1 son cruciales para el control del riesgo cardiovascular en la diabetes tipo 2.
Se necesitan estrategias de implementación mejoradas para mejorar el acceso de los pacientes a estas terapias beneficiosas.

Palabras clave:

Agonistas de los receptores GLP-1 riesgo cardiovascular la diabetes Hormonas de la incretina acontecimientos cardiovasculares mayores Infarto de miocardio

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