Oral Antidiabetic Agents and Cardiovascular Outcomes

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Manan Pareek1, Deepak L Bhatt2

  • 1Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA, United States; Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark; Department of Endocrinology, Odense University Hospital, Odense, Denmark.

Current Problems in Cardiology
|August 29, 2017
PubMed

Insights

Tight glycemic control

Area of Science:

  • Endocrinology
  • Cardiology
  • Pharmacology

Background:

  • Cardiovascular disease (CVD) is a major complication in type 2 diabetes (T2D).
  • The cardiovascular safety of oral antidiabetic agents is now a regulatory requirement.
  • Previous understanding of antidiabetic drug cardiovascular effects was limited.

Purpose of the Study:

  • To review major cardiovascular outcome trials (CVOTs) of oral antidiabetic agents.
  • To summarize findings for dipeptidyl peptidase-4 inhibitors and sodium-glucose cotransporter-2 inhibitors.
  • To discuss mechanisms, limitations, and future research directions.

Main Methods:

  • Review of 4 completed cardiovascular outcome trials (CVOTs).
  • Focus on trials involving dipeptidyl peptidase-4 inhibitors (saxagliptin, alogliptin, sitagliptin) and a sodium-glucose cotransporter-2 inhibitor (empagliflozin).
  • Noninferiority trial designs in high-risk T2D populations.

Main Results:

  • Summarized cardiovascular safety data from three DPP-4 inhibitors and one SGLT-2 inhibitor.
  • Provided insights into the cardiovascular effects of these oral antidiabetic classes.
  • Highlighted the importance of rigorous cardiovascular safety assessments.

Conclusions:

  • Cardiovascular outcomes trials have increased our understanding of antidiabetic drug safety.
  • Specific drug classes like SGLT-2 inhibitors show promise in managing cardiovascular risk in T2D.
  • Ongoing research is crucial for further elucidating the role of these agents in T2D management.

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