Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 72, Issue 15, Pages 1856-1869Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2018.07.071
Keywords
antidiabetic therapy; cardiovascular disease; primary prevention; secondary prevention; type 2 diabetes
Categories
Funding
- National Heart, Lung, and Blood Institute of the National Institutes of Health [K23HL125991, HL114978]
- American Heart Association
- Amarin
- Sanofi
- Akcea
- Ionis
- AstraZeneca
- Janssen
- Merck/Pfizer
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Type 2 diabetes mellitus (T2D) is a major risk factor for cardiovascular disease (CVD), the most common cause of death in T2D. Despite improved risk factor control, however, adults with T2D continue to experience substantial excess CVD risk. Until recently, however, improved glycemic control has not been associated with robust macrovascular benefit. The advent of 2 new classes of antihyperglycemic agents, the sodium-glucose cotransporter-2 inhibitors and the glucagon-like peptide-1 receptor agonists, and their respective large cardiovascular outcome trials, has led to a paradigm shift in how cardiologists and heath care practitioners conceptualize T2D treatment. Herein, the authors review the recent trial evidence, the potential mechanisms of action of the sodium-glucose cotransporter-2 inhibitors and the glucagon-like peptide-1 receptor agonists, safety concerns, and their use for the primary prevention of CVD as well as in diabetic patients with impaired renal function and heart failure. (C) 2018 by the American College of Cardiology Foundation.
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