Incremental prognostic value of global longitudinal strain in patients with type 2 diabetes mellitus

Background: Patients with type 2 diabetes mellitus (T2DM) are at high risk for cardiovascular events. The aim of the study was to assess whether global longitudinal strain (GLS) provides prognostic value in these patients. Methods: A total of 247 T2DM patients without history of cardiovascular complications and participated in the CDATS study were prospectively enrolled. Left ventricular (LV) systolic function was assessed by LV ejection fraction and speckle tracking derived LV systolic GLS. Diastolic function was assessed by E/E′ ratio defined as the passive trans-mitral LV inflow velocity to tissue Doppler imaging velocity of the medial mitral annulus. Cardiovascular event included acute coronary syndrome, cerebrovascular stroke, hospitalization for heart failure and cardiovascular death. Results: A total of 18 cardiovascular events occurred during a median follow-up duration of 33 months. Both E/E′ ratio [hazard ratio (HR) 1.15, P 
Source: Cardiovascular Diabetology - Category: Cardiology Authors: Source Type: research

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Conclusion: Incretins [dipeptidyl peptidase-4 inhibitors (DPP-4i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA)] and sodium-glucose linked transporter-2 inhibitors (SGLT-2i) therapy steadily decreases the HbA1c level, and risk of developing diabetic incidents is reduced to between 333 and 465 cases among 6122 treated patients. Avoided cost for therapy of diabetes incidents account for between 305 and 510 thousand BGN. Introduction Incretin (DPP-4i and GLP-1 RA) and SGLT-2i groups are now routinely used for type 2 diabetes therapy and comprise a large number of medicinal products (Cheung et al., 2009; Lov...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Canagliflozin protects Heart and Kidneys – CREDENCE Trial Canagliflozin is sodium–glucose cotransporter 2 (SGLT2) inhibitor used in the treatment of type 2 diabetes mellitus. CREDENCE Trial [1] has shown that Canagliflozin provides both cardiovascular and renal protection in patients with type 2 diabetes mellitus. CREDENCE (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) trial was a double blind randomized trial comparing Canagliflozin 100 mg daily with placebo in type 2 diabetes with albuminuria and chronic kidney disease. They were also treated with renin–ang...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs
ConclusionThis meta-analysis demonstrated that GLP-1RAs were associated with a significant reduction in MACE, CV death, stroke, and death from any cause, while DPP-4 inhibitors were comparable to placebo for all CV outcomes, including hospitalizations for HF.
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
Conclusion Activation of the Nrf2-dependent antioxidant system plays an important role in cell defense against oxidative stress damage, whereas the insufficiency of the Nrf2 system is associated with multiple aspects of the genesis and progression of metabolic diseases, posing a great risk to the cardiovascular system (Figure 1). The systemic increase of Nrf2 activity by several activators may be beneficial in the treatment of metabolic diseases. In addition, selective upregulation of Nrf2 genes may represent a potential therapy in obesity, diabetes and atherosclerosis. Looking to the future, experimental research that el...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusion The high prevalence of comorbidities in patients with stroke indicates the need for therapies in preclinical studies that take into account these comorbidities in order to avoid failures in translation to the patient. Preclinical studies are beginning to evaluate the efficacy of MSC treatment in stroke associated with comorbidities, especially hypertension, for ischemic and hemorrhagic stroke. Regarding aging and diabetes, only ischemic stroke studies have been performed. For the moment, few studies have been performed and contradictory results are being reported. These contradictory results may be due to the u...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
This study demonstrated that the incidence of ischemic heart disease and death were three times higher among men with low birth weight compared to men with high birth weight (5). Epidemiological investigations of adults born at the time of the Dutch famine between 1944 and 1945 revealed an association between maternal starvation and a low infant birth weight with a high incidence of hypertension and coronary heart disease in these adults (23). Furthermore, Painter et al. reported the incidence of early onset coronary heart disease among persons conceived during the Dutch famine (24). In that regard, Barker's findin...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
AbstractEnvironmental noise is a well ‐recognized health risk and part of the external exposome—the World Health Organization estimates that 1 million healthy life years are lost annually in Western Europe alone due to noise‐related complications, including increased incidence of hypertension, heart failure, myocardial infarction, and stroke. Previous data suggest that noise works through two paired pathways in a proposed reaction model for noise exposure. As a nonspecific stressor, chronic low‐level noise exposure can cause a disruption of sleep and communication leading to annoyance and subsequent sympathetic...
Source: BioFactors - Category: Biochemistry Authors: Tags: Review Article Source Type: research
Authors: Raschi E, Poluzzi E, Marchesini G, De Ponti F Abstract INTRODUCTION: Individuals with type 2 diabetes mellitus (T2DM) have increased cardiovascular risk with regulatory agencies requiring cardiovascular outcome trials (CVOTs) for the approval of new antidiabetic drugs. Areas covered: In this paper, the authors critically discuss the background, trial design, results and implications of a recent CVOT [NCT01730534; DECLARE-TIMI 58 study], which demonstrated that dapagliflozin was non-inferior to placebo in terms of major adverse cardiovascular events, and superior for the occurrence of hospitalization for he...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
CONCLUSIONS: Patients with T2DM and prior MI are at high risk of MACE and CV death/HHF. Dapagliflozin appears to robustly reduce the risk of both composite outcomes in these patients. Future studies should aim to confirm the large clinical benefits with SGLT2i we observed in patients with prior MI. CLINICAL TRIAL REGISTRATION: URL: Unique Identifier: NCT01730534. PMID: 30882239 [PubMed - as supplied by publisher]
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
CONCLUSION: The current analysis showed that treatment with DPP-4 inhibitors did not significantly increase cardiovascular outcomes in these patients with T2DM indicating that those drugs might be safe to use in terms of cardiovascular events. PMID: 30832701 [PubMed - in process]
Source: BMC Pharmacology and Toxicology - Category: Drugs & Pharmacology Tags: BMC Pharmacol Toxicol Source Type: research
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