Updated Meta-analysis Assessing the Effect of Sodium-Glucose Co-transporter-2 Inhibitors On Surrogate Endpoints In Patients with Heart Failure with Reduced Ejection Fraction

Type 2 diabetes mellitus (T2DM) represents a major health problem,1 contributing to 11.3% of deaths globally.2 Cardiovascular disease (CVD) still affects a large proportion of patients,3 despite the fact that incidence rates of cardiovascular outcomes have decreased over the last two decades.4 Heart failure (HF) is a main contributor of cardiovascular morbidity and mortality among patients with T2DM,5 who feature an almost twofold increase in the risk of HF, with women having a greater risk compared to men.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research

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AbstractPurpose of ReviewThis narrative review makes the case for greater efforts to reduce cardiovascular disease (CVD) risk in women with diabetes.Recent FindingsIn a recent meta-analysis including five CVOTs of diabetes medications with 46,606 subjects, women (vs men) with type 2 diabetes had a higher relative risk for stroke (RR 1.28; 95% CI 1.09, 1.50) and heart failure (1.30; 1.21, 1.40). Prior studies found higher “within-gender” RR for CVD mortality in women with diabetes although men have an absolute higher risk. Women with prior gestational diabetes mellitus (GDM) have a 2-fold higher CVD risk than th...
Source: Current Diabetes Reports - Category: Endocrinology Source Type: research
Abstract Background: In patients with type 2 diabetes mellitus (T2DM), sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure (HHF). We assessed the effect of ertugliflozin on HHF and related outcomes. Methods: VERTIS CV, a double-blind, placebo-controlled trial, randomized patients with T2DM and atherosclerotic cardiovascular (CV) disease to once-daily ertugliflozin 5 mg, 15 mg or placebo. Prespecified secondary analyses compared ertugliflozin (pooled doses) versus placebo on time to first event of HHF and composite of HHF/CV death, overall and stratified by prespec...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Adults with obesity and type 2 diabetes mellitus (T2DM) related to obesity are at increased risk of heart failure with preserved ejection fraction (HFpEF). Whether left ventricular (LV) diastolic function abno...
Source: Cardiovascular Diabetology - Category: Cardiology Authors: Tags: Original investigation Source Type: research
AbstractBackgroundSeveral clinical trials of dapagliflozin in patients with type 2 diabetes mellitus (T2DM) at elevated cardiovascular risk have observed reduced hospitalization for heart failure (HHF). Several studies have also suggested cardiovascular benefits for patients with HF regardless of whether or not they have T2DM.ObjectiveThis meta-analysis was conducted to evaluate the therapeutic effects of dapagliflozin in patients with HF.MethodsThe PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched from database inception to 15 February 2020. Clinical studies of dapagliflozin use i...
Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research
Cardiorespiratory fitness (CRF) is an important prognostic indicator of morbidity and mortality in patients with heart failure (HF), especially in those with comorbid type 2 diabetes mellitus (T2DM). Bioelectrical impedance analysis (BIA) is an objective and reproducible method to estimate the edema index (EI), a surrogate for extracellular volume status. Whether an increase in the EI estimated by BIA can identify patients with reduced CRF is unknown. We hypothesized that in patients with HF and reduced ejection fraction (HFrEF) and T2DM, an increased EI would inversely correlate with measures of CRF.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 130 Source Type: research
Authors: Orime K, Terauchi Y Abstract INTRODUCTION: Saxagliptin, a member of the dipeptidyl peptidase-4 inhibitor (DPP-4i) class of drugs, was approved by the FDA for the treatment of type 2 diabetes (T2D) in 2009, and has been in clinical use for more than a decade. Since the drug was first launched, much real-world evidence has also been accumulated. The efficacy and safety of saxagliptin, especially its cardiovascular safety, are of particular interest. AREAS COVERED: This review provides an overview of the safety and efficacy of saxagliptin based on observational studies, pharmacovigilance, and meta-analyse...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
Whereas selective sodium-glucose cotransporter 2 (SGLT2) inhibitors consistently showed cardiovascular protective effects in large outcome trials independent of the presence of type 2 diabetes mellitus (T2DM),...
Source: Cardiovascular Diabetology - Category: Cardiology Authors: Tags: Original investigation Source Type: research
CONCLUSIONS: The observed effects of empagliflozin versus placebo on cardiovascular and kidney outcomes were consistent across the KDIGO risk categories, indicating that the effect of treatment benefit of empagliflozin was unaffected by baseline CKD status. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: EMPA-REG OUTCOME, NCT01131676. PMID: 32994159 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - Category: Urology & Nephrology Authors: Tags: Clin J Am Soc Nephrol Source Type: research
Abstract With worsening epidemiological trends for both the incidence and prevalence of type 2 diabetes mellitus (T2DM) and heart failure (HF) worldwide, it is critical to implement optimal prevention and treatment strategies for patients with these comorbidities, either alone or concomitantly. Several guidelines and consensus statements have recommended glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter type 2 inhibitors as add-ons to lifestyle interventions with or without metformin in those at high atherosclerotic cardiovascular disease risk. However, these recommendations are either sil...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
AbstractPurpose of reviewAppropriate selection of anti-hyperglycemic agents that are both safe and effective is critical to improve outcomes for individuals with heart failure. Although emerging evidence supports the use of sodium-glucose co-transporter 2 (SGLT2) inhibitors for heart failure patients with or without diabetes, barriers to prescribing these agents still exist. This comprehensive review will focus on evidence supporting SGLT2 inhibitors for patients with heart failure and practical considerations when prescribing these agents in clinical practice.Recent findingsBased on evidence of improved cardiovascular out...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
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