Cardiovascular Safety of Oral Antidiabetic Drugs
نویسنده
چکیده
SAŽETAK: Hrvatska pripada skupini europskih zemalja s visokim kardiovaskularnim rizikom i rastućom prevalencijom šećerne bolesti tipa 2 (DMT2). Prema podatcima Nacionalnog registra osoba sa šećernom bolešću (CroDiab registar), u Hrvatskoj je 2014. godine bilo evidentirano ukupno 254 296 osoba oboljelih od dijabetesa starijih od 18 godina (7,9 %). DMT2 je, uz hipertenziju i hiperlipidemiju, jedan od vodećih čimbenika kardiovaskularnog rizika. Glavne regulatorne agencije za lijekove, potaknute štetnim kardiovaskularnim učincima rosiglitazona u RECORD studiji i kasnijim metaanalizama, zahtijevaju za sve antidijabetike kliničke pokuse o utjecaju na kardiovaskularne ishode i dokaze o sigurnosti. U procjeni učinka antidijabetika na kardiovaskularni rizik važna je gornja granična vrijednost dvostranog intervala pouzdanosti od 95 % (95 % CI) za procijenjeni omjer rizika. Svi antidijabetici s gornjom granicom omjera rizika ≥ 1,3 zahtijevaju dodatne sigurnosne provjere. Kardiovaskularna sigurnost oralnih antidijabetika posebno je važna u bolesnika sa zatajivanjem srca. S obzirom na veliki broj antidijabetika na tržištu, odluka o optimalnom liječenju DMT2 treba ovisiti o svim individualnim karakteristikama bolesnika i procijenjenom kardiovaskularnom riziku.
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