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Mechanistic View on the Effects of SGLT2 Inhibitors on Lipid Metabolism in Diabetic Milieu
J Clin Med. 2022 Nov 4;11(21):6544. doi: 10.3390/jcm11216544.ABSTRACTChronic hyperglycemia induces pathophysiologic pathways with negative effects on the metabolism of most substrates as well as lipids and lipoproteins, and thereby induces dyslipidemia. Thus, the diabetic milieu is commonly accompanied by different levels of atherogenic dyslipidemia, which is per se a major risk factor for subsequent complications such as atherosclerosis, coronary heart disease, acute myocardial infarction, ischemic stroke, and nephropathy. Therefore, readjusting lipid metabolism in the diabetic milieu is a major goal for preventing dyslip...
Source: Atherosclerosis - November 11, 2022 Category: Cardiology Authors: Habib Yaribeygi Mina Maleki Željko Reiner Tannaz Jamialahmadi Amirhossein Sahebkar Source Type: research

Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium-Glucose Cotransporter-2 Inhibitors Versus Metformin : A Cohort Study
CONCLUSION: As first-line T2D treatment, initiators receiving SGLT-2i showed a similar risk for MI/stroke/mortality, lower risk for HHF/mortality and HHF, and a similar safety profile except for an increased risk for genital infections compared with those receiving metformin.PRIMARY FUNDING SOURCE: Brigham and Women's Hospital and Harvard Medical School.PMID:35605236 | DOI:10.7326/M21-4012
Source: Annals of Internal Medicine - May 23, 2022 Category: Internal Medicine Authors: HoJin Shin Sebastian Schneeweiss Robert J Glynn Elisabetta Patorno Source Type: research

Effects of Sodium/Glucose Cotransporter 2 (SGLT2) Inhibitors and Combined SGLT1/2 Inhibitors on Cardiovascular, Metabolic, Renal, and Safety Outcomes in Patients with Diabetes: A Network Meta-Analysis of 111 Randomized Controlled Trials
ConclusionsIn patients with T2DM, compared with pure SGLT2 inhibitors, combined SGLT1/2 inhibitors demonstrated a lower risk of myocardial infarction and of stroke, but were associated with a higher risk of diarrhea and severe hypoglycemia.
Source: American Journal of Cardiovascular Drugs - March 22, 2022 Category: Cardiology Source Type: research

Gliflozins for the prevention of stroke in diabetes and cardiorenal diseases: A meta-analysis of cardiovascular outcome trials
Conclusions: Gliflozins, especially canagliflozin and sotagliflozin, should be recommended in T2D patients with CKD to prevent stroke. Most gliflozins lower the risk of MACE in T2D patients regardless of HF status and ASCVD status, whereas ertugliflozin is not observed to lower that risk.
Source: Medicine - October 1, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Comparing the clinical outcomes across different sodium/glucose cotransporter 2 (SGLT2) inhibitors in heart failure patients: a systematic review and network meta-analysis of randomized controlled trials
ConclusionsThere were no demonstrable treatment differences across SGLT2 inhibitors across cardiovascular, renal, and metabolic outcomes, although this needs to be interpreted considering the wide confidence intervals, limited number of included studies, and heterogeneity present. Future research of different SGLT2 inhibitors in head-to-head studies is warranted to determine if there is a drug class effect.
Source: European Journal of Clinical Pharmacology - September 21, 2021 Category: Drugs & Pharmacology Source Type: research

Comparative efficacy of 5 sodium glucose cotransporter 2 inhibitor and 7 glucagon-like peptide 1 receptor agonists interventions on cardiorenal outcomes in type 2 diabetes patients: A network meta-analysis based on cardiovascular or renal outcome trials
Conclusions: This updated network meta-analysis reproduced the findings in the first network meta-analysis, and moreover revealed that sotagliflozin was one of the most effective drugs as for lowering MI, stroke, MACE, and HHF, whereas ertugliflozin was not. These findings will provide the according evidence regarding the usage of specific SGLT2 inhibitors and GLP-1 RAs in T2D patients for prevention of specific cardiorenal endpoints.
Source: Medicine - July 30, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Canagliflozin for Prevention of Cardiovascular and Renal Outcomes in type2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Conclusion: This meta-analysis suggests that canagliflozin protects against cardiovascular and renal outcomes in patients with T2DM.Systematic Review Registration: [https://www.crd.york.ac.uk/prospero], identifier [CRD42020210315]
Source: Frontiers in Pharmacology - July 19, 2021 Category: Drugs & Pharmacology Source Type: research

Comparative Efficacy of Five SGLT2i on Cardiorenal Events: A Network Meta-analysis Based on Ten CVOTs
ConclusionsCanagliflozin, dapagliflozin, empagliflozin, ertugliflozin, and sotagliflozin versus placebo reduce HHF but none reduces MI and stroke. Canagliflozin is most effective in reducing MACE and HHF, and empagliflozin is most effective in reducing CVD, CVD or HHF, KFP, and ACD. These findings will guide the use of specific SGLT2i in the prevention of different cardiorenal events.
Source: American Journal of Cardiovascular Drugs - July 7, 2021 Category: Cardiology Source Type: research

Comparing the clinical outcomes across different sodium/glucose cotransporter 2 (SGLT2) inhibitors in heart failure patients: a systematic review and network meta-analysis of randomized controlled trials
ConclusionsThere were no demonstrable treatment differences across SGLT2 inhibitors across cardiovascular, renal, and metabolic outcomes, although this needs to be interpreted considering the wide confidence intervals, limited number of included studies, and heterogeneity present. Future research of different SGLT2 inhibitors in head-to-head studies is warranted to determine if there is a drug class effect.
Source: European Journal of Clinical Pharmacology - May 3, 2021 Category: Drugs & Pharmacology Source Type: research

Cardiovascular and renal outcomes with canagliflozin according to baseline diuretic use: a post hoc analysis from the CANVAS Program
ConclusionsParticipants on baseline diuretics derived a greater benefit for major cardiovascular events from canagliflozin, which was not fully explained by differences in participant characteristics nor risk factor changes.
Source: ESC Heart Failure - February 17, 2021 Category: Cardiology Authors: Jie Yu, Clare Arnott, Brendon L. Neuen, Hiddo L. Heersprink, Kenneth W. Mahaffey, Christopher P. Cannon, Sadiya S. Khan, Abigail S. Baldridge, Sanjiv J. Shah, Yuli Huang, Chao Li, Gemma A. Figtree, Vlado Perkovic, Meg J. Jardine, Bruce Neal, Tags: Original Research Article Source Type: research

Macrovascular Risk Equations Based on the CANVAS Program
ConclusionThese risk equations address some of the limitations of widely used risk equations, such as the UKPDS-OM2, for modeling cardioprotective treatments for individuals with T2DM and high cardiovascular risk, including derivation from overly healthy patients treated with agents that lack cardioprotection and have been described as reflecting a different therapeutic era. Future work is needed to examine external validity.
Source: PharmacoEconomics - February 13, 2021 Category: Health Management Source Type: research

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