Сердечно-сосудистые эффекты ингибиторов дипептидилпептидазы-4

Taking into account the risk of cardiovascular diseases in patients with type 2 diabetes and the need for longterm treatment, when choosing glucose-lowering therapy, preference should be given to glucose-lowering drugs, which, as they reduce the risk of developing cardiovascular complications (CVC), especially in the presence of confirmed atherosclerotic CVD, or concomitant chronic kidney disease (CKD). Inhibition of dipeptidyl peptidase-4 (i-DPP-4) is an established therapy for lowering blood glucose levels in DM 2. DPP 4 drugs have a low risk of hypoglycemia and other adverse events and are not associated with weight gain. More recently, i-DPP-4 is increasingly replacing sulfonylureas as second-line therapy after metformin, and there are many fixed dose combinations of the metformin / DPP-4 inhibitor. DPP-4 inhibitors are also recommended in guidelines for triple therapy with metformin and sodium glucose transport protein 2 (SGLT2) inhibitors or with metformin and insulin. This review will focus on the analysis of cardiovascular safety in the clinical use of IDP-4 in patients with coronary artery disease and diabetes mellitus 2.