Frederik H Verbrugge1. 1. Department of Cardiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk, Belgium. frederik.verbrugge@zol.be.
Abstract
PURPOSE OF REVIEW: This review aims to summarize the evidence on cardiovascular risks and benefits of glucose-lowering drugs in diabetic patients, with a particular focus on the role of sodium-glucose transporter-2 (SGLT-2) inhibitors and their promising potential as a heart failure treatment. RECENT FINDINGS: The SGLT-2 inhibitor empagliflozin has emerged as the first glucose-lowering drug to lower cardiovascular mortality in diabetes with an unprecedented 38% relative risk reduction. In addition, empagliflozin significantly reduced the rate of heart failure admissions with 35% when compared to placebo in diabetic patients with established atherosclerosis. SGLT-2 inhibitors should be considered as a first-line drug to achieve glycemic control in diabetic patients at high risk for cardiovascular diseases and heart failure in particular. As SGLT-2 inhibitors target different pathophysiological pathways in heart failure, they might even be considered in the broader population without diabetes, but this remains the topic of further study.
PURPOSE OF REVIEW: This review aims to summarize the evidence on cardiovascular risks and benefits of glucose-lowering drugs in diabeticpatients, with a particular focus on the role of sodium-glucose transporter-2 (SGLT-2) inhibitors and their promising potential as a heart failure treatment. RECENT FINDINGS: The SGLT-2 inhibitor empagliflozin has emerged as the first glucose-lowering drug to lower cardiovascular mortality in diabetes with an unprecedented 38% relative risk reduction. In addition, empagliflozin significantly reduced the rate of heart failure admissions with 35% when compared to placebo in diabeticpatients with established atherosclerosis. SGLT-2 inhibitors should be considered as a first-line drug to achieve glycemic control in diabeticpatients at high risk for cardiovascular diseases and heart failure in particular. As SGLT-2 inhibitors target different pathophysiological pathways in heart failure, they might even be considered in the broader population without diabetes, but this remains the topic of further study.
Authors: Benjamin M Scirica; Deepak L Bhatt; Eugene Braunwald; P Gabriel Steg; Jaime Davidson; Boaz Hirshberg; Peter Ohman; Robert Frederich; Stephen D Wiviott; Elaine B Hoffman; Matthew A Cavender; Jacob A Udell; Nihar R Desai; Ofri Mosenzon; Darren K McGuire; Kausik K Ray; Lawrence A Leiter; Itamar Raz Journal: N Engl J Med Date: 2013-09-02 Impact factor: 91.245
Authors: William B White; George L Bakris; Richard M Bergenstal; Christopher P Cannon; William C Cushman; Penny Fleck; Simon Heller; Cyrus Mehta; Steven E Nissen; Alfonso Perez; Craig Wilson; Faiez Zannad Journal: Am Heart J Date: 2011-09-14 Impact factor: 4.749
Authors: Bruce Neal; Vlado Perkovic; Dick de Zeeuw; Kenneth W Mahaffey; Greg Fulcher; Peter Stein; Mehul Desai; Wayne Shaw; Joel Jiang; Frank Vercruysse; Gary Meininger; David Matthews Journal: Am Heart J Date: 2013-06-24 Impact factor: 4.749
Authors: Philip D Home; Stuart J Pocock; Henning Beck-Nielsen; Paula S Curtis; Ramon Gomis; Markolf Hanefeld; Nigel P Jones; Michel Komajda; John J V McMurray Journal: Lancet Date: 2009-06-06 Impact factor: 79.321
Authors: F J Lavalle-González; A Januszewicz; J Davidson; C Tong; R Qiu; W Canovatchel; G Meininger Journal: Diabetologia Date: 2013-09-13 Impact factor: 10.122
Authors: David Z I Cherney; James W Scholey; Shan Jiang; Ronnie Har; Vesta Lai; Etienne B Sochett; Heather N Reich Journal: Diabetes Care Date: 2012-07-26 Impact factor: 19.112
Authors: Steven P Marso; Gilbert H Daniels; Kirstine Brown-Frandsen; Peter Kristensen; Johannes F E Mann; Michael A Nauck; Steven E Nissen; Stuart Pocock; Neil R Poulter; Lasse S Ravn; William M Steinberg; Mette Stockner; Bernard Zinman; Richard M Bergenstal; John B Buse Journal: N Engl J Med Date: 2016-06-13 Impact factor: 176.079
Authors: Bernard Zinman; Silvio E Inzucchi; John M Lachin; Christoph Wanner; Roberto Ferrari; David Fitchett; Erich Bluhmki; Stefan Hantel; Joan Kempthorne-Rawson; Jennifer Newman; Odd Erik Johansen; Hans-Juergen Woerle; Uli C Broedl Journal: Cardiovasc Diabetol Date: 2014-06-19 Impact factor: 9.951
Authors: HoJin Shin; Sebastian Schneeweiss; Robert J Glynn; Elisabetta Patorno Journal: Pharmacoepidemiol Drug Saf Date: 2022-01-17 Impact factor: 2.890