Cardiovascular effects of semaglutide: Multifaceted mechanisms of systemic organoprotection

Type 2 diabetes mellitus (T2DM) is a multifactorial disease that is an independent risk factor for severe cardiovascular prognosis. Along with T2DM, obesity is also recognized as one of the most important risk factors for cardiovascular diseases (CVD), the prevalence of which has reached epidemic proportions. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are an innovative class of hypoglycemic drugs that affect not only metabolic disorders, but also various tissues and organs. Representatives of the incretin family of GLP-1 RA have unique pleiotropic effects, an extensive evidence base, high metabolic efficiency and safety. The article provides a detailed review of clinical studies conducted with this group of hypoglycemic drugs. Semaglutide deserves special attention among the GLP-1 RA drugs, which showed excellent results in large randomized clinical trials not only in terms of glycemic control and weight loss, but also cardio- and nephroprotective properties compared to other drugs of this class. At present, semaglutide is the first GLP-1 RA that demonstrated a favorable effect on the main endpoints of major adverse cardiovascular events (MACE), the course and risk of atherosclerotic CVD and chronic heart failure in both patients with T2DM and in patients with obesity. This allows the drug to be used not only for the treatment of T2DM, but also for the treatment of obesity and reduction of the risk of CVD. Thus, the improvement in the quality of life of patients with both metabolic disorders and CVD during GLP-1 RA therapy opens up new horizons for the use of these drugs in various fields of medicine.

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