Cardiovascular Protection in the Treatment of Type 2 Diabetes: A Review of Clinical Trial Results Across Drug Classes
Open accessAbstract
Patients with type 2 diabetes (T2DM) have a significantly higher risk of developing cardiovascular disease (CVD)-namely myocardial infarction, heart failure, and stroke.Despite clear advances in the prevention and treatment of CVD, the impact of T2DM on CVD outcome remains high and continues to escalate.Available evidence indicates that the risk of macrovascular complications increases with the severity of hyperglycemia, thus suggesting that the relation between metabolic disturbances and vascular damage is approximately linear.Although current antidiabetic drugs are highly effective for the management of hyperglycemia, most T2DM patients remain exposed to a substantial and concrete risk of CVD.Over the last decade many glucose-lowering agents have been tested for their safety and efficacy in T2DM with CVD.Noteworthy, most of these studies failed to show a significant benefit in terms of CV morbidity and mortality, despite intensive glycemic control.The recent trials Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus PatientseRemoving Excess Glucose (EMPA-REG OUTCOME); Trial to Evaluate Cardiovascular and Other Long-term Outcomes with Semaglutide in Subjects with Type 2 Diabetes (SUSTAIN-6); Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER); and Insulin Resistance Intervention After Stroke (IRIS) have shed some light on this important clinical issue, thus showing a convincing effect of empagliflozin, liraglutide, and pioglitazone on CVD outcomes.Here we provide a critical and updated overview of the main glucose-lowering agents and their risk/benefit ratio for the prevention of CVD in patients with T2DM.
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Thiazolidinediones increase the risk of heart failure in patients with diabetes.
“The thiazolidinediones increase the risk of heart failure in patients with diabetes.207”
From The Vasculature in Prediabetes (2018) · cites this paper as [207]
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- Authors
- Paneni, F., & Lüscher, T. F.
- Affiliations
- University of Zurich (CH)
- Corresponding author
- Paneni, Francesco
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2017-07
- Volume
- 120
- Issue
- 1
- Pages
- S17-S27
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W4235892613
- Cited by
- 83
- References
- 78
- Citations by year
- 2025: 1 · 2024: 6 · 2023: 4 · 2022: 11 · 2021: 5 · 2020: 13 · 2019: 13 · 2018: 20 · 2017: 10
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The American Journal of Cardiology (publishedVersion, cc-by-nc-nd)
- Funders
- National Science Foundation
- Boehringer Ingelheim
- Foundation for Cardiovascular Research
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Universität Zürich
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, cardiovascular disease, cardioprotection, glucose-lowering agents, empagliflozin, liraglutide, pioglitazone, SGLT2 inhibitors, GLP-1 receptor agonists, thiazolidinediones, cardiovascular risk, hyperglycemia, EMPA-REG OUTCOME, SUSTAIN 6, leaders, IRIS trial
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