Sodium-glucose cotransporter-2 inhibitors(SGLT2i),including empagliflozin,dapagliflozin,and canagliflozin,are now widely approved antihyperglycemic therapies.Although initially considered to be only glucose-lowering a...Sodium-glucose cotransporter-2 inhibitors(SGLT2i),including empagliflozin,dapagliflozin,and canagliflozin,are now widely approved antihyperglycemic therapies.Although initially considered to be only glucose-lowering agents,the effects of SGLT2i have expanded far beyond that,and their use is now being studied in the treatment of heart failure and chronic kidney disease,even in patients without diabetes.Because of their unique glycosuric mechanism,SGLT2i also reduce weight.Perhaps more important are the osmotic diuretic and natriuretic effects contributing to plasma volume contraction,and decreases in systolic and diastolic blood pressures by 4 to 6 and 1 to 2 mm Hg,respectively,which may underlie cardiovascular and kidney benefits.展开更多
Atrial fibrillation(AF)catheter ablation,usually performed in patients on oral anticoagulation—either traditional vitamin K antagonists(VKAs)or non-vitamin K antagonist oral anticoagulants(NOACs)-entails contrasting ...Atrial fibrillation(AF)catheter ablation,usually performed in patients on oral anticoagulation—either traditional vitamin K antagonists(VKAs)or non-vitamin K antagonist oral anticoagulants(NOACs)-entails contrasting risks:on the one hand,a risk of major bleeding,including hemopericardium,and on the other hand,a high transient procedure-related risk of thromboembolism that necessitates particularly rigorous anticoagulation throughout the procedure.展开更多
文摘Sodium-glucose cotransporter-2 inhibitors(SGLT2i),including empagliflozin,dapagliflozin,and canagliflozin,are now widely approved antihyperglycemic therapies.Although initially considered to be only glucose-lowering agents,the effects of SGLT2i have expanded far beyond that,and their use is now being studied in the treatment of heart failure and chronic kidney disease,even in patients without diabetes.Because of their unique glycosuric mechanism,SGLT2i also reduce weight.Perhaps more important are the osmotic diuretic and natriuretic effects contributing to plasma volume contraction,and decreases in systolic and diastolic blood pressures by 4 to 6 and 1 to 2 mm Hg,respectively,which may underlie cardiovascular and kidney benefits.
文摘Atrial fibrillation(AF)catheter ablation,usually performed in patients on oral anticoagulation—either traditional vitamin K antagonists(VKAs)or non-vitamin K antagonist oral anticoagulants(NOACs)-entails contrasting risks:on the one hand,a risk of major bleeding,including hemopericardium,and on the other hand,a high transient procedure-related risk of thromboembolism that necessitates particularly rigorous anticoagulation throughout the procedure.
