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The Evolving Role of the Cardiologist in the Management of Type 2 Diabetes
AbstractPurpose of ReviewTo evaluate the treatment of type 2 diabetes from a cardiologist ’s view.Recent FindingsA new era in the treatment of type 2 diabetes began for the cardiologist in 2015 with the publication of the EMPA-REG outcome trial finding a significant reduction in CV death with empagliflozin (oral sodium-glucose co-transporter-2 [SGLT2] inhibitor) in patients with type 2 diabetes at increased cardiovascular risk. Shortly thereafter, the injectable glucagon-like peptide agonists (GLP-1) liraglutide and semaglutide found a significant reduction in composite major cardiovascular events (CV death, non-fatal MI...
Source: Current Diabetes Reports - November 8, 2018 Category: Endocrinology Source Type: research

Clinical implications of cardiovascular outcome trials in type  2 diabetes.
Clinical implications of cardiovascular outcome trials in type 2 diabetes. Herz. 2019 Feb 25;: Authors: Mellbin LG, Wang A, Rydén L Abstract Cardiovascular disease (CVD) is the main reason for premature death in patients with type 2 diabetes. Hyperglycemia, the hallmark of diabetes, has long been considered the link between diabetes and CVD, and many trials focused on preventing CVD manifestations by means of tight glucose control. However, diabetes is a multifactorial disease in which, e. g., insulin resistance, endothelial dysfunction, and factors such as hypertension and dyslipidemia contrib...
Source: Herz - February 27, 2019 Category: Cardiology Tags: Herz Source Type: research

Dapagliflozin and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Prior Myocardial Infarction: A Sub-analysis From DECLARE TIMI-58 Trial.
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: https://clinicaltrials.gov Unique Identifier: NCT01730534. PMID: 30882239 [PubMed - as supplied by publisher]
Source: Circulation - March 17, 2019 Category: Cardiology Authors: Furtado RHM, Bonaca MP, Raz I, Zelniker TA, Mosenzon O, Cahn A, Kuder J, Murphy SA, Bhatt DL, Leiter LA, McGuire DK, Wilding JPH, Ruff CT, Nicolau JC, Gause-Nilsson IAM, Fredriksson M, Langkilde AM, Sabatine MS, Wiviott SD Tags: Circulation Source Type: research

Dapagliflozin and cardiovascular outcomes: anything else to DECLARE?
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 - March 30, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

YiQiFuMai Powder Injection Attenuates Coronary Artery Ligation-Induced Heart Failure Through Improving Mitochondrial Function via Regulating ROS Generation and CaMKII Signaling Pathways
This study was carried out in accordance with the recommendations of “Guide for the Care and Use of Laboratory Animals, National Institutes of Health.” The protocol was approved by the “China Pharmaceutical University.” Surgical Preparation The mice were anesthetized with chloral hydrate (4% chloral hydrate, ip). The HF model was induced by CAL as previously reported (Gao et al., 2010). Successful ligation of the coronary artery was confirmed by the occurrence of ST-segment elevation in electrocardiogram. Sham operated mice were performed the same process except left CAL. After ligation, the h...
Source: Frontiers in Pharmacology - April 9, 2019 Category: Drugs & Pharmacology Source Type: research

Atrial Transcriptional Profiles of Molecular Targets Mediating Electrophysiological Function in Aging and Pgc-1 β Deficient Murine Hearts
Conclusion: These findings limit the possible roles of gene transcriptional changes in previously reported age-dependent pro-arrhythmic electrophysiologial changes observed in Pgc-1β-/- atria to an altered Ca2+-ATPase (Atp2a2) expression. This directly parallels previously reported arrhythmic mechanism associated with p21-activated kinase type 1 deficiency. This could add to contributions from the direct physiological outcomes of mitochondrial dysfunction, whether through reactive oxygen species (ROS) production or altered Ca2+ homeostasis. Introduction Atrial arrhythmias constitute a major public health pro...
Source: Frontiers in Physiology - April 23, 2019 Category: Physiology Source Type: research

Impaired Activity of Ryanodine Receptors Contributes to Calcium Mishandling in Cardiomyocytes of Metabolic Syndrome Rats
Conclusion Principal findings of this work are that abnormal Ca2+ transient amplitude, contractile dysfunction; and impaired relaxation of MetS cardiomyocytes underlies intrinsic dysfunctional RyR2 and SERCA pump. Abnormal activity of RyRs was evidenced by its decreased ability to bind [3H]-ryanodine. Although the MetS condition does not modify RyR2 protein expression, its phosphorylation at Ser2814 is decreased, which impairs its capacity for activation during ECC. The dysfunctional RyRs, together with a decreased activity of SERCA pump due to decreased Thr17-PLN phosphorylation suggest a downregulation of CaMKII in MetS...
Source: Frontiers in Physiology - April 29, 2019 Category: Physiology Source Type: research

Summary: International Kidney Cancer Symposium
Conclusions:  Ideal ischemia time is 20-25 minutes or less improves short and long term renal function. >25 minutes carried 5 year risk of new onset stage 4 CKD No differences on GFR for cold vs. warm ischemia times Preoperative GFR and the percent of kidney preserved was a better predictor of post op GFR.  No ischemia preserves renal function better than warm. Longer cold ischemia times were equivalent to shorter warm ischemia times. Quality and quantity of the remaining kidney is associated with ultimate renal function. Robotics in RCC Surgery Gennady Bratslavsky, MD The opening question ...
Source: Kidney Cancer Association - December 15, 2011 Category: Urology & Nephrology Source Type: news

Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study
We describe the prevalence, hazard ratios (HRs), and population-attributable fractions (PAFs) for cardiovascular disease and mortality associated with a cluster of behavioural factors (ie, tobacco use, alcohol, diet, physical activity, and sodium intake), metabolic factors (ie, lipids, blood pressure, diabetes, obesity), socioeconomic and psychosocial factors (ie, education, symptoms of depression), grip strength, and household and ambient pollution. Associations between risk factors and the outcomes were established using multivariable Cox frailty models and using PAFs for the entire cohort, and also by countries grouped ...
Source: The Lancet - September 3, 2019 Category: General Medicine Source Type: research

Prevalence of Established Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus in the UK
ConclusionApproximately one-third of patients with T2DM in the UK have concomitant CVD.FundingMerck Sharp& Dohme Corp., a subsidiary Merck& Co., Inc., Kenilworth, NJ, USA.
Source: Diabetes Therapy - October 3, 2019 Category: Endocrinology Source Type: research

The Cardiovascular Effects of SGLT2 Inhibitors
Publication date: Available online 24 September 2019Source: Canadian Journal of DiabetesAuthor(s): Vincent C. WooAbstractIndividuals with type 2 diabetes mellitus can benefit from pharmacotherapies that lower their risk for cardiovascular disease. This review describes the salient findings from sodium-glucose cotransporter-2 (SGLT2) inhibitor cardiovascular outcome trials that serendipitously revealed the cardiorenal benefits of SGLT2 inhibitors in individuals with type 2 diabetes mellitus who either have established cardiovascular disease or multiple cardiovascular risk factors. It also summarizes the findings from other ...
Source: Canadian Journal of Diabetes - November 29, 2019 Category: Endocrinology Source Type: research

Cardiovascular Effects of Sodium-Glucose Cotransporter-2 Inhibitors in Adults With Type 2 Diabetes
Publication date: Available online 24 September 2019Source: Canadian Journal of DiabetesAuthor(s): Vincent C. WooAbstractAdults with type 2 diabetes mellitus can benefit from pharmacotherapies that lower their risk for cardiovascular disease. This review describes the salient findings from sodium-glucose cotransporter-2 (SGLT2) inhibitor cardiovascular outcome trials that serendipitously revealed the cardiorenal benefits of SGLT2 inhibitors in adults with type 2 diabetes mellitus who either have established cardiovascular disease or multiple cardiovascular risk factors. It also summarizes the findings from other phase 3 cl...
Source: Canadian Journal of Diabetes - December 13, 2019 Category: Endocrinology Source Type: research

Heart Failure End Points in Cardiovascular Outcome Trials of Sodium Glucose Cotransporter 2 Inhibitors in Patients With Type 2 Diabetes Mellitus: A Critical Evaluation of Clinical and Regulatory Issues.
This report summarizes these discussions and the key takeaway messages from this meeting. PMID: 31841369 [PubMed - in process]
Source: Circulation - December 16, 2019 Category: Cardiology Authors: Butler J, Packer M, Greene SJ, Fiuzat M, Anker SD, Anstrom KJ, Carson PE, Cooper LB, Fonarow GC, Hernandez AF, Januzzi JL, Jessup M, Kalyani RR, Kaul S, Kosiborod M, Lindenfeld J, McGuire DK, Sabatine MS, Solomon SD, Teerlink JR, Vaduganathan M, Yancy CW, Tags: Circulation Source Type: research

Sodium Handling and Interaction in Numerous Organs.
Abstract Salt (NaCl) is a prerequisite for life. Excessive intake of salt, however, is said to increase disease risk including hypertension, arteriosclerosis, heart failure, renal disease, stroke, and cancer. Therefore, considerable research has been expended on the mechanism of sodium handling based on the current concepts of sodium balance. The studies have necessarily relied on relatively short-term experiments and focused on extremes of salt intake in humans. Ultra-long-term salt balance has received far less attention. We performed long-term salt balance studies at intakes of 6, 9, and 12 g/day and found that...
Source: American Journal of Hypertension - March 20, 2020 Category: Cardiology Authors: Minegishi S, Luft FC, Titze J, Kitada K Tags: Am J Hypertens Source Type: research

Correlation among high salt intake, blood pressure variability, and target organ damage in patients with essential hypertension: Study protocol clinical trial (SPIRIT compliant)
This study is a cross-sectional study. It will recruit 600 patients with essential hypertension in the outpatient and inpatient department of cardiovascular medicine of Chengdu Fifth People's Hospital. Researchers will obtain blood and urine samples with the patient's informed consent. In addition, we will measure patient's blood pressure and target organ-related information. Trial registry: The study protocol was approved by the Chengdu Fifth People's Hospital. Written informed consent will be obtained from all the participants. The trial was registered in the Chinese Clinical trial registry, ChiCTR2000029243. This tri...
Source: Medicine - April 1, 2020 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

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