499
HLAVNÍ42522001005185134178232252
TÉMA69222001003981147194
SGLT242533001003782113146182
inhibitory6233300100145290105143158185224248287
v926330010035
kardiologii,9773300100336993131146185201240278293308324
nefrologii13173300100377293118156172211250265280
a1613330010034
diabetologii:16633300100375287125161188226242281319335350365
kdo204433001003471110
je217033001001450
„must-have“,223633001002888126155182204241276312347374386
jak26383300100144983
je273733001001550
nasazovat280333001003772100136168206241277303
a3122330010034
kdy317233001003371107
vysazovat329533001003674104140171209244280306
36018822001003477122
|350220010019
VNITŘNÍ4268040010746106127172220280301
LÉKAŘSTVÍ748804001074185130188236280325378400
/11948040010731
Vnitř1270804001074693112140166
Lék.1456804001074083122140
2026;72(6):360-3631615804001074487129171186227271292334356371415459504534574618661
/23218040010731
www.casopisvnitrnilekarstvi.cz442680400107651332012142542953293774274464795215705896176436927117307748128548809159449871007102310631101
https://doi.org/10.36290/vnl.2026.06842544001003865941331631802022236484400100418310274944001001554791171398904400100287389124167204247293316355396414432470516552594611655698740
SGLT24259800275115252363475608
inhibitory11109800275601883163825115766667908831015
v22029800275120
kardiologii,23709800275121242334463529654720846974104011061177
nefrologii362498002751232413334245506167428709361002
a42512400275116
diabetologii:588124002751241893114395586487738399651093115912251294
kdo195912400275121246372
je24081240027561179
„must-have“,266412400275972854135186067018299511073118812851347
jak4251500027560182309
je8111500027560178
nasazovat1066150002751232443494715767008229411031
a217415000275116
kdy233715000275122247375
vysazovat2789150002751212543564785837078299481038
Jan4251890013745103168
Škrha6151890013760119162226284
3.425204001335678
interní526204001332686121175211272297
klinika846204001335279104164189240293
1.1163204001335673
LF12592040013352105
UK13872040013372131
a15412040013353
VFN,16172040013362116186209
Praha1849204001335993146206259
SGLT24252550012149115163207261
inhibitory711255001212480136160218243277332366417
neboli11542550012155106165221246270
glifloziny,1450255001215680104134162218261285341388405
původně18802550012157113163218276332384
vyvinuté22892550012148100152177233289323373
jako2688255001212473121176
perorální28892550012157109143198232282306362386
antidiabetika33012550012148104138162219243292350402436460508558
s38852550012139
mírným39502550012183107141198244329
diuretickým4305255001215680136169220255279325372423508
a48392550012148
glykosurickým4912255001215681129178232273328362386432479531616
efektem,425269001215081132180217268352374
se821269001213991
postupně9342690012157113154189245302359410
staly1366269001214075124149197
základním1585269001214394141167216274330355439
pilířem2046269001215781105129166216301
léčby2369269001212375121179226
srdečního2617269001213973130181228284308366422
selhání3061269001214091116172221277302
a33842690012149
chronického34542690012145101135190247271317364414471527
onemocnění40032690012155111163247304350406458514538
ledvin,4563269001212475133183208264286
a48712690012148
to4941269001213388
bez50512690012156108153
ohledu52252690012155112137188246302
na4252830012155104
přítomnost548283001215790114148202286341397437471
diabetu.1039283001215679128185236270325347
Tento1405283001215094150183237
článek1662283001214468116172223270
má19522830012183131
za2103283001214293
cíl221528300121446894
shrnout2328283001214095128185240296329
aktuální2677283001214895131186235259314338
postavení30352830012156112152187236283332388412
SGLT2i34672830012149113161205258280
napříč37672830012155103160194218263
obory40492830012155112168202252
vnitřního43212830012148104128162194251274332387
lékařství,4728283001212374122171204245279331355376
definovat51242830012156107137164219275322371404
optimálního4252970012155113147171255304329385409467523
pacienta9762970012157107153176228284318368
pro1371297001215791147
jejich1546297001212475100124170226
nasazení18002970012155104144194239290347371
a21982970012149
poskytnout22742970012157114154202253291347403460494
praktický2795297001215791141189225249295343394
návod32172970012155104152207265
pro3510297001215791146
jejich3684297001212476100125170227
bezpečný39382970012157109153211264310366413
management,43792970012183132188237294346430482538572594
se5001297001213991
zvláštním5119297001214395120169209244300324409
zřetelem425311001214377127162212237288373
na8213110012156105
perioperační9493110012157109143167223281333367417463519543
péči.15153110012157109156179201
Klíčová425328001235885111155211261312
slova:758328001234268124174225248
SGLT210273280012149114161204257
inhibitory,1305328001212479134157214237271325358408424
glifloziny,1750328001215679102132158213255279334379395
srdeční2166328001214072128179224279303
selhání,2490328001213990114169217272295316
chronické28273280012145100132187243266311357406
onemocnění32543280012155111161245300346401451507530
ledvin,3805328001212474131180203259279
euglykemická41063280012150105161184232279328412435480526576
ketoacidóza.4703328001214796129183232277300356411453503524
SGLT24253530015063136195255326
inhibitors7893530015033101170204273307355421470525
in13533530015033101
cardiology,14923530015053117167235270337371438507575607
nephrology,21373530015067130199267317384418486554623654
and28303530015063131200
diabetes30693530015067101166235298346408464
care:35713530015052117166230265
who38753530015091159226
should41393530015054122189257292361
take45383530015046112179241
them,48173530015047115179279317
how51723530015067134225
to4253670015046113
start5763670015054101166215265
treatment,879367001504696159224271373436504552590
and15073670015064132201
when17463670015092159222291
to20753670015047113
discontinue22273670015067101157210277345392427495563627
SGLT24253870012149113161204256
inhibitors,699387001212378133156212236269323355396417
also1133387001214872110165
known13163870012147104158231287
as1621387001214887
gliflozins,1725387001215679102131158212254277332371392
were21353870012173123155205
originally2358387001215487110166189244292315338385
developed27613870012156106154203227281338389446
as3225387001214887
oral3330387001215587136159
antidiabetic35073870012148103135158214237285341392425448493
agents40173870012149104154210242282
with4317387001217397130185
mild45203870012183106129185
diuretic4723387001215679134166216249272316
and50573870012148103160
glycosuric5234387001215679126170224263425401001215588111156
effects;602401001215080113163209244285304
they928401001213388138185
have11344010012156104150199
gradually1355401001215688137193248296320343390
become17674010012156107153207290341
a21294010012149
cornerstone2199401001214598131187238271311345399455505
of2725401001215584
treatment2831401001213365115163196279330385418
for3270401001212984117
heart34094010012155106154186222
failure3652401001213079102125180212262
and39354010012149104160
chronic41174010012145100132187242266310
kidney4449401001214771128183234280
disease,4751401001215679118169217256307326
regardless5099401001213382139187220276299350389428
of425415001215584
the531415001213388139
presence692415001215790140179230285330379
of1094415001215484
diabetes.1200415001215679127184235268318357378
This16014150012149106129168
article1791415001214881117140184208258
aims2071415001214871155194
to2287415001213387
summarize2396415001214094177261309341365408458
the2876415001213388138
current3037415001214499132165215270303
status3362415001213973122155210249
of3633415001215584
SGLT2i37394150012150114162205257279
across4040415001214893126180219259
internal4321415001212378111160193249297320
medicine46634150012184134192215259282338388
specialties,5073415001214096147193216264287320343394433454
define4254290012156107136163218268
the712429001213389139
optimal8704290012155112145168251299323
patient12124290012157105138161211267299
for1530429001212984117
their1666429001213389139163195
use,1880429001215594145165
and20644290012148103160
provide2243429001215790144191215272322
practical2584429001215790138183218241286335358
guidance29614290012156111134191239294339388
for3368429001212984117
their3504429001213388139162195
safe3718429001213988117168
management,39054290012183131187235290341424475531563584
with4508429001217497130185
particular47124290012157106139175198242297320368401
emphasis51324290012150134190246294333356395
on4254430012155111
perioperative5574430012157108141164219276328360409441464513562
care.1140443001214594126176196
Key4254600012358108158
words:6044600012374130166224266290
SGLT29154600012149114161204257
inhibitors,1193460001212479134157214237271325358398419
gliflozins,1633460001215679102132158213255279334373394
heart20484600012156106154187222
failure,2292460001212978101124179211261281
chronic25944600012145100133187243266311
kidney2926460001214772128184234281
disease,3228460001215679119169217256307327
euglycemic35764600012150105161185232276325408432476
ketoacidosis.4074460001214695129183232276299356411450473512534
Úvod4255070013874137198262
Poslední565524001074692126144188239287305
dekáda895524001075094132175224265
přinesla118552400107517796144189222241281
v14925240010741
diabetologii1558524001075068109158203231278297346396414433
myšlenkový20165240010775113147166210258296343384427
zlom.2468524001073757105180196
Léčba2689524001074184125175216
diabetu425538001074967106154198225272
2.712538001074458
typu785538001072769118166
(DM2)965538001072481150193214
již119453800107193672
není1281538001074891138155
striktně145153800107346287106142172220263
glukocentrická1728538001074967113150196237278325351377395434471512
a22555380010741
naopak2311538001074887135184224261
ovlivňuje2587538001074887106123163211257275318
celou425552001074082100147194
řadu634552001072767116162
významných811552001074183121169209282329366405452
komorbidit.1278552001073884157205231280299347364392407
SGLT21700552001074297136172216
inhibitory1931552001071966113130179197224270296338
(SGLT2i,2284552001072463118158193237254268
inhibitory2567552001071966113131179197225270296338
sodíko-glukózového425566001073481130148187233262312330376413460494540580622670717
kotransportéru1164566001073884111136177224256305353379409451476524
2)1710566001074365
neboli1796566001074992141189208225
glifloziny,204356600107496784107129176211229276314324
původně2389566001075097137184233280323
vyvinuté2734566001074083126145425580001074895122164
jako60558000107205996143
perorální764580001075094120166192233251297315
antidiabetika1096580001074188114132180198237286330357375411453
s15665800010733
mírným1616580001077491117165202276
diuretickým1909580001074966113138180207225264301343417
a23435800010741
glykosurickým2400580001074967106144191223269295313353390432505
efektem,425594001074365106142171212283297
se736594001073375
postupně824594001074996128155201248295337
staly1174594001073360100117155
základním1343594001073576112130169216262279350
pilířem170759400107486683100127168239
léčby1959594001071961100147184
srdečního2157594001073357103145184230247295341
selhání251259400107337593138177223240
(HF)2765594001072478117140
a4256080010741
chronického481608001074087112158206223262299341388436
onemocnění932608001074795138211258298346389436453
ledvin1400608001071962111151170216
(CKD),1631608001072472116174195208
a18546080010740
to1909608001072873
bez1997608001075094130
ohledu2142608001074895113156205252
na2408608001074888
přítomnost251160800107507593120166239286334366394
diabetu.425622001074967106155199226273288
Aktuální735622001075390120167207225272289
postavení1046622001075098131159199238281328345
SGLT2i1414622001074197136172216232
napříč1668622001074988137163181220
obory1910622001074897146172214
vnitřního2146622001074089106133159207224273321
lékařství248962200107196299141166199228270289
tak2800622001072868105
ukazuje425636001074885126163210228271
význam714636001074183121169209281
těchto1013636001072869110157183228
léků1259636001071962100147
v14246360010740
moderní14826360010774122171214240288305
farmakoterapii.180563600107246590164204241287314355381421470488506521
Proč4256610013867113176226
mění6886610013891150214247
SGLT2i9726610013858126182238305335
guidelines13446610013862126159223282315348412471523
Historický565678001075779114145195224246289329375
milník970678001077596117168189231
představovala1232678001075079125178213245289331381424469490533
studie1796678001073465116168189236
EMPA-REG20636780010742115163213242292337396
OUTCOME,24906780010761121166219279352397415
která425692001073973120150195
jako653692001072064106157
první843692001075282130183204
prokázala,1081692001075181132174221261308330374393
že1507692001073784
empagliflozin16246920010745124177223276298319347372425464486538
u21956920010749
pacientů2278692001075196140162210262292344
s26556920010735
DM227236920010760135182
a30475100010741
preexistujícím3117510001075079123170212232267298348368389430451526
kardiovaskulárním3672510001073983111161181231273316352391441462504532583603679
(KV)4380510001072470121151
onemocněním4560510001074898144220270313363409459479554
snižuje5144510001073383103141191212258
KV5431510001074596
mortalitu30475240010773123152184227247267297346
o34135240010748
383481524001074388
%35895240010766
a36755240010741
riziko373552400107274886107146194
hospitalizace3949524001074898133184204234277297317355399441485
pro4454524001074978126
srdeční4600524001073361110156198248268
selhání488852400107337999149191240260
o51685240010748
355236524001074386
%53425240010766
(1).54285240010724658499
Tento3047538001074282132161209
benefit3281538001074996146192218239269
byl3575538001074990112
nezávislý3711538001074995134178219241275296337
na4073538001074891
poklesu41885380010750101141163209245294
glykovaného4506538001074970111152201243287336382433483
hemoglobinu5013538001074894170220272293343395416465515
(HbA1c).30475520010725851381943237558006326503289552001072541
Následovaly33625520010759103140162209264316360405427471
studie,3864552001073567119173194242259
které4155552001073974120150196
definitivně4383552001075198125148200222253275320372420
etablovaly4835552001074576121175198250294339361405
SGLT2i52715520010744104148188237257
v30475660010741
kardiologii.3108566001073882110160180229251301352373393411
DAPA-HF35395660010758110156205233293336
a38965660010740
EMPEROR-Reduced39565660010742114161203250312360389437483535584626670722
prokázaly4698566001074978127167211250294314356
signifikantní5074566001073454104154174200221261305354383433453
snížení3047580001073484105144189240260
KV3338580001074597
mortality34665800010774125154188231252273303348
a38455800010741
hospitalizací3917580001074899135187208238282303324363408451471
pro4419580001075079129
HF,45785800010757101110
a47185800010742
to4790580001072877
i48985800010719
u49475800010748
pacientů5026580001075094137158204254284334
bez5390580001075098137
diabetu,3047594001074969112163210240289307
u33845940010747
pacientů3461594001075093136156202252281330
se3821594001073480
srdečním3931594001073361111157200250270346
selháním4307594001073379100150193242263338
s46755940010734
redukovanou4739594001072671123172212261303347397447497
ejekční5266594001074364110150191241261
frakcí304760800107245396136177198
(HFrEF)3265608001072482125152195238265
(2,355060800107246986
3).365660800107446782
Následně37586080010758100135156202253303349
studie4127608001073465115166186232
EMPEROR-Preserved43796080010742114161204250313360389438466510546592620666711763
a51626080010741
DELIVER52236080010758102144165213258304
jako3047622001071961101150
první3222622001075079124175196
v34436220010740
historii3508622001074869103134183211232253
prokázaly3786622001074978127167211250295315357
zásadní4168622001073680116159210260281
benefit4474622001074996146192217239269
(snížení4768622001072458107127166210260281
kompozitního50746220010738871632142653023233534034243047636001074898
cíle317463600107406183129
KV3332636001074596
úmrtí34576360010748123152184205
a36916360010741
hospitalizace3761636001074898133184205235278299319358402444488
pro4278636001075079128
HF)44346360010757101127
i45906360010719
u46386360010748
pacientů4715636001074993135155201251280329
se5073636001073480
srdečním5182636001073361111157200250270345
selháním3047650001073379100150192242262337
se3404650001073379
zachovalou3503650001073680123172222264307328378428
ejekční3951650001074364109149190239260
frakcí423165000107235396135176197
(HFpEF),4448650001072481125174218260287302
pro4770650001075078127
které4917650001073871115143188
do5125650001074998
té5244650001072771
doby5336650001074898150191
neexistovala3047664001074894141182203238269317359402423466
efektivní3536664001074469114154187207250301321
léčba3881664001071965108159202
(4,410666400107246784
5).421366400107446984
Nefrologické31876780010758103127155203223272323342383421465
studie3679678001073463112162181226
CREDENCE,3931678001075298141199242300352394411
DAPA-CKD,43696780010758109155203230285330391404
EMPA-KIDNEY48006780010742113159207234281302361420462510
navíc5336678001074990131151191
jasně304769200107195890136179
demonstrovaly3241692001074891162209256288316342387426466484523
zpomalení3779692001073685132204244262304351369
progrese4163692001074974120168194235268311
renální4489692001072667114153171218235
insuficience473969200107196597143166184223241283330369410
a51656920010740
oddálení5220692001074795143182201243290307
MUDr.425740009562112164189200
Jan64374000952764107
Škrha7677400095377196140176
jr.,961740009517415266
Ph.D.10457400095408297150163
3.42575200953953
interní4957520095176084122146190207
klinika7197520095345370113129163201
1.93875200953949
LF100575200953573
UK109575200955090
a1203752009536
VFN125775200954079129
jan.skrha2@vfn.cz4257640095175396111142176201245281320377414438483497534568
Cit.43807400095466388103
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Vnitř462574000954183100125149
Lék.479274000953674109125
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