Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 69, Issue 21, Pages 2646-2656Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2017.04.014
Keywords
blood glucose; cardiovascular disease; heart failure; hypoglycemic agents; outcomes
Categories
Funding
- AstraZeneca
- Amgen
- Sanofi
- Boehringer Ingelheim
- Eli Lilly
- Novo Nordisk
- Janssen
- Takeda
- Novartis
- Maquet
- Pfizer
- Daiichi-Sankyo
- Servier
- Hutter Family Professorship
- Siemens
- Singulex
- Prevencio
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Recently, treatment with 2 newer classes of type 2 diabetes drugs were found to reduce events in patients with diabetes and cardiovascular (CV) disease, a group common in cardiology clinics. The sodium-glucose cotransporter 2 inhibitor, empagliflozin, markedly and rapidly reduced CV death and heart failure hospitalization, likely with hemodynamic/metabolic-driven mechanisms of action. More recently, the glucagon-like peptide-1 receptor agonists liraglutide and semaglutide also reduced CV death and/or major adverse CV events, but did so more slowly and did not influence heart failure risks, suggesting alternative mechanisms of benefit. We will discuss drug therapy for diabetes relative to CV risk, briefly summarize key findings of CV benefit from recent trials, discuss potential mechanisms for benefits of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 agonists, and suggest how such drugs might be embraced by CV specialists to reduce CV events and mortality in their patients. (J Am Coll Cardiol 2017;69:2646-56) (C) 2017 by the American College of Cardiology Foundation.
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