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Dapagliflozin and cardiovascular outcomes in patients with Type 2 diabetes

Dalal Y Al-Bazz1, John Ph Wilding2,1

  • 1Department of Diabetes and Endocrinology, Clinical Sciences Centre, Aintree University Hospital, Liverpool, L9 7AL, UK.

Future Cardiology
|January 10, 2020
PubMed

Insights

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) demonstrate cardiovascular benefits, including reduced heart failure (HF) hospitalizations. Dapagliflozin showed efficacy in Type-2 diabetes (T2DM) patients and those with HF, highlighting its role in managing cardiorenal risk.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Type-2 diabetes (T2DM) significantly increases cardiovascular disease (CVD) and heart failure (HF) risk.
  • New glucose-lowering agents require cardiovascular (CV) outcome trials to assess CV risk.
  • SGLT2 inhibitors have demonstrated notable CV benefits, including reduced HF events.

Purpose of the Study:

  • To review the CV benefits of SGLT2 inhibitors, focusing on dapagliflozin.
  • To analyze the DECLARE-TIMI 58 trial results for dapagliflozin in T2DM patients.
  • To discuss the implications of dapagliflozin in HF management, referencing the DAPA-HF trial.

Main Methods:

  • Review of pivotal clinical trials, including DECLARE-TIMI 58 and DAPA-HF.
  • Analysis of data on major adverse cardiovascular events (MACE), HF hospitalizations, and CV mortality.
  • Focus on dapagliflozin's efficacy in diverse patient populations with T2DM and/or HF.

Main Results:

  • DECLARE-TIMI 58 showed dapagliflozin was noninferior for MACE and reduced HF hospitalizations and CV mortality in T2DM patients.
  • DAPA-HF confirmed dapagliflozin's benefits in patients with HF with reduced ejection fraction, irrespective of T2DM status.
  • SGLT2 inhibitors, particularly dapagliflozin, offer significant CV protection.

Conclusions:

  • Dapagliflozin demonstrates a favorable CV safety profile and provides significant benefits in reducing HF events and mortality.
  • The findings support the use of dapagliflozin in patients with T2DM and HF.
  • SGLT2 inhibitors represent a crucial therapeutic class for managing cardiorenal risk in T2DM.
Keywords:
CVDDECLARESGLT2iT2DMdapagliflozin

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