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[Evidence-based reduction of cardiovascular risk in patients with diabetes]

Katharina A Schütt1

  • 1Medizinische Klinik I - Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland. kschuett@ukaachen.de.

Herz
|December 11, 2019
PubMed

Insights

Patients with type 2 diabetes face higher cardiovascular risks. Novel medications like DPP-4 inhibitors, SGLT2 inhibitors, and GLP-1 receptor agonists offer new strategies to reduce this risk, as outlined in recent ESC guidelines.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes mellitus significantly elevates the risk of cardiovascular diseases, including myocardial infarction, stroke, and heart failure.
  • Recent advancements in hypoglycemic agents have introduced novel therapeutic classes with demonstrated cardiovascular benefits.

Purpose of the Study:

  • To summarize evidence from major cardiovascular outcome trials on novel hypoglycemic agents.
  • To discuss updated treatment algorithms for managing cardiovascular risk in diabetic patients based on new evidence and guidelines.

Main Methods:

  • Review of large-scale cardiovascular outcome trials involving dipeptidyl peptidase 4 (DPP-4) inhibitors, sodium-glucose transporter 2 (SGLT2) inhibitors, and glucagon-like peptide 1 (GLP-1) receptor agonists.
  • Analysis of European Society of Cardiology (ESC) guidelines concerning diabetes and cardiovascular diseases.

Main Results:

  • Novel hypoglycemic agents, specifically SGLT2 inhibitors and GLP-1 receptor agonists, have shown significant reductions in cardiovascular events.
  • DPP-4 inhibitors have a neutral effect on major adverse cardiovascular events in most patient populations, though some agents may offer specific benefits.

Conclusions:

  • The integration of SGLT2 inhibitors and GLP-1 receptor agonists into treatment algorithms is crucial for reducing cardiovascular risk in type 2 diabetes.
  • Current European guidelines recommend these agents for cardiovascular risk reduction in addition to glycemic control for eligible patients.
Keywords:
Heart failureHypoglycemic agentsMyocardial infarctionOutcome trialsStroke

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