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Cardiovascular Disease and Type 2 Diabetes: Has the Dawn of a New Era Arrived?
- Source :
-
Diabetes care [Diabetes Care] 2017 Jul; Vol. 40 (7), pp. 813-820. - Publication Year :
- 2017
-
Abstract
- Hyperglycemia is the major risk factor for microvascular complications in patients with type 2 diabetes (T2D). However, cardiovascular disease (CVD) is the principal cause of death, and lowering HbA <subscript>1c</subscript> has only a modest effect on reducing CVD risk and mortality. The recently published LEADER and SUSTAIN-6 trials demonstrate that, in T2D patients with high CVD risk, the glucagon-like peptide 1 receptor agonists liraglutide and semaglutide reduce the primary major adverse cardiac events (MACE) end point (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke) by 13% and 24%, respectively. The EMPA-REG OUTCOME, IRIS (subjects without diabetes), and PROactive (second principal end point) studies also demonstrated a significant reduction in cardiovascular events in T2D patients treated with empagliflozin and pioglitazone. However, the benefit of these four antidiabetes agents (liraglutide, semaglutide, empagliflozin, and pioglitazone) on the three individual MACE end points differed, suggesting that different underlying mechanisms were responsible for the reduction in cardiovascular events. Since liraglutide, semaglutide, pioglitazone, and empagliflozin similarly lower the plasma glucose concentration but appear to reduce CVD risk by different mechanisms, there emerges the intriguing possibility that, if used in combination, the effects of these antidiabetes agents may be additive or even multiplicative with regard to cardiovascular benefit.<br /> (© 2017 by the American Diabetes Association.)
- Subjects :
- Animals
Benzhydryl Compounds pharmacology
Benzhydryl Compounds therapeutic use
Cardiovascular Diseases etiology
Diabetes Mellitus, Type 2 complications
Glucagon-Like Peptides pharmacology
Glucagon-Like Peptides therapeutic use
Glucosides pharmacology
Glucosides therapeutic use
Humans
Hyperglycemia complications
Hyperglycemia drug therapy
Liraglutide pharmacology
Liraglutide therapeutic use
Pioglitazone
Randomized Controlled Trials as Topic
Risk Factors
Thiazolidinediones pharmacology
Thiazolidinediones therapeutic use
Treatment Outcome
Cardiovascular Diseases prevention & control
Diabetes Mellitus, Type 2 drug therapy
Hypoglycemic Agents therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1935-5548
- Volume :
- 40
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Diabetes care
- Publication Type :
- Academic Journal
- Accession number :
- 28637886
- Full Text :
- https://doi.org/10.2337/dc16-2736