Medicine
Medicine
2024-11-22 05:18
Senk
Semaglutide and Cardiovascular Health: A New Frontier in Weight Loss Treatment
Recent breakthroughs in medical research have highlighted the dual benefits of certain weight-loss medications, particularly semaglutide, in addressing obesity and its associated cardiovascular risks. Emerging data suggests that semaglutide may not only aid in weight reduction but also significantly reduce the incidence of major adverse cardiac events (MACE) in individuals with cardiovascular disease (CVD), even in the absence of diabetes.
The SELECT Trial: A Landmark Study
The SELECT trial, a large-scale, double-blinded, randomized study, enrolled over 17,600 participants aged 45 and older, all with a BMI of at least 27 kg/m² and established cardiovascular disease. Approximately 25% of participants had heart failure at baseline. Participants were divided to receive either semaglutide 2.4 mg weekly or a placebo over 34 months, with follow-up lasting an average of 39 months.
Key findings include:
• 28% reduction in MACE among participants with heart failure.
• Decreased risk of cardiovascular death by 24% and all-cause mortality by 19%.
• Similar efficacy in heart failure subtypes: 35% reduction in MACE for heart failure with reduced ejection fraction (HFrEF) and 31% for heart failure with preserved ejection fraction (HFpEF).
• Consistent benefits across age, gender, BMI, and heart failure severity.
How Semaglutide Works
Semaglutide is a glucagon-like peptide 1 (GLP-1) receptor agonist. It mimics the GLP-1 hormone, promoting insulin secretion, lowering blood sugar, and influencing brain areas controlling appetite. These mechanisms contribute to weight loss and cardiovascular benefits, likely through reduced inflammation, improved lipid profiles, and lowered blood pressure.
Beyond Weight Loss: Cardiac Benefits
The SELECT trial findings align with other studies emphasizing GLP-1 receptor agonists’ potential to improve cardiovascular health. For example:
• In heart failure patients, semaglutide improved symptoms and exercise capacity.
• Another GLP-1 agonist, tirzepatide, demonstrated reductions in left ventricular mass and epicardial adipose tissue, suggesting structural cardiac improvements.
Semaglutide’s benefits were also evident in patients with a history of coronary artery bypass grafting (CABG). In these individuals, semaglutide reduced MACE more effectively than in non-CABG patients, showcasing its utility in high-risk populations.
Safety and Tolerability
While generally safe, semaglutide may cause gastrointestinal side effects such as nausea, which often resolve with dosage adjustments. Its cardiovascular and metabolic benefits far outweigh these temporary issues, particularly for patients with obesity and established CVD.
Implications for Clinical Practice
These findings redefine semaglutide from a diabetes and weight-loss drug to a transformative therapy for cardiovascular disease prevention. With obesity and heart disease prevalence rising globally, semaglutide offers hope for a broader patient demographic, including those without diabetes.
Future Directions
Ongoing research focuses on the intricate relationship between obesity, inflammation, and cardiovascular health. Investigators aim to refine GLP-1 receptor agonist therapies, optimizing their application in diverse patient populations.
Conclusion
Semaglutide represents a paradigm shift in managing obesity and cardiovascular disease. As clinicians and researchers continue to explore its full potential, this drug underscores the growing recognition of the interplay between metabolic health and heart disease.
Inzucchi, Silvio E., et al.
"Tirzepatide and Cardiac Structure in Heart Failure with Preserved Ejection Fraction: Secondary
Analysis of the SUMMIT Trial." The New England Journal of Medicine, vol. 384, no. 19, 2024, рр.
1883-1891.
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Antibiotics
2024-10-18 12:12
The link between arthritis drugs and chronic COVID-19 disease is being revealed
Researchers at the University of Virginia College of Medicine have identified a possible cure for chronic respiratory symptoms after discovering an unknown cause of the condition in the lungs.
Researchers at the University of Virginia, led by Dr. Ji Sun, found that infection with Covid-19 causes radical changes in immune cells in lung tissue, causing scarring and persistent inflammation even after the initial infection has passed.
They believe this persistent infection causes chronic respiratory symptoms, such as cough and difficulty breathing, associated with chronic Covid-1
Can chronic inflammation be stopped?
The new study suggests that doctors may be able to stop this chronic inflammation by using a class of drugs, including baricitinib, previously used to treat rheumatoid arthritis, an anti-inflammatory drug that previously received emergency approval from the Federal Food and Drug Administration It is seen in Covid-1
"Our study identified the underlying cause of chronic respiratory complications of Covid by comparing both clinical samples and a related animal model," said Sun, of the University of Virginia's Carter Center for Immunology Research and Department of Infection to design "clinical studies in a rational manner, in order to reuse these FDA-approved drugs to treat chronic Covid-19 infections.
For these patients, infection with COVID-19 turns into a seemingly endless trial, with symptoms lasting weeks, months, or even years.
Symptoms of chronic COVID-1
Symptoms of chronic COPD can range from discomfort to weakness, for example respiratory symptoms can include shortness of breath, chest pain and even chronic lung scarring known as interstitial lung disease.
Previous studies on chronic COVID-19 looked for answers in patients' blood, but Sun and his team wanted to see what changes occurred in the lung tissue itself, so researchers at the University of Virginia looked at cell samples collected from the lower airways of both laboratory mice and human patients.
In both cases, they found that immune cells known as macrophages and T cells had gone mad and reacted defectively and harmfully.
These cells normally help the body fight disease, but in this case, they have not stopped fighting, even after the initial infection has passed.
What conclusions did the researchers reach?
The researchers found that macrophages poured into the lungs in abnormal numbers and developed tissue scars. Meanwhile, the T cells were secreting a substance called interferon, which stimulates ongoing inflammation.
Sun and his team believe that doctors may be able to break this cycle of inflammation by using drugs already approved to treat the damaging inflammation seen in rheumatoid arthritis, a chronic autoimmune disease that affects the joints.
More research will be needed, but Sun hopes the University of Virginia's new findings will lead to much-needed new treatments for patients with chronic respiratory symptoms.
Source: Medical Express
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