Type 2 diabetes mellitus (T2DM) has evolved as a pandemic of the 21st century, while
cardiovascular disease (CVD) affects almost one third of patients and represents the
cause of death in more than half cases, with coronary artery disease, heart failure
(HF), and stroke being the main contributors.
1
Hallmark cardiovascular outcome trials published during the last five years have
established a novel class of antidiabetics, namely sodium-glucose co-transporter-2
(SGLT-2) inhibitors as a primary treatment option in patients with HF, atherosclerotic
cardiovascular disease, or chronic kidney disease, along with the use of metformin
(unless not tolerated or contraindicated).
2
Of note, the Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure (DAPA-HF)
trial demonstrated significant cardiovascular benefit (risk for HF decompensation
or cardiovascular death) for patients with HF with reduced ejection fraction, regardless
of T2DM status, extending the therapeutic potential of this drug class beyond diabetic
subjects.
- Buse JB
- Wexler DJ
- Tsapas A
- Rossing P
- Mingrone G
- Mathieu C
- D'Alessio DA
- Davies MJ
2019 update to: management of hyperglycemia in Type 2 diabetes, 2018. A consensus
report by the American Diabetes Association (ADA) and the European Association for
the Study of Diabetes (EASD) [published correction appears in Diabetes Care. 2020
Jul;43(7):1670].
Diabetes Care. 2020; 43: 487-493
3
Despite the undoubted cardiovascular benefits observed with SGLT-2 inhibitors, the
underlying mechanisms of their action remain largely unknown.- McMurray JJV
- Solomon SD
- Inzucchi SE
- Køber L
- Kosiborod MN
- Martinez FA
- Ponikowski P
- Sabatine MS
- Anand IS
- Bělohlávek J
- Böhm M
- Chiang CE
- Chopra VK
- de Boer RA
- Desai AS
- Diez M
- Drozdz J
- Dukát A
- Ge J
- Howlett JG
- Katova T
- Kitakaze M
- Ljungman CEA
- Merkely B
- Nicolau JC
- O'Meara E
- Petrie MC
- Vinh PN
- Schou M
- Tereshchenko S
- Verma S
- Held C
- DeMets DL
- Docherty KF
- Jhund PS
- Bengtsson O
- Sjöstrand M
- Langkilde AM
DAPA-HF Trial Committees and Investigators
Dapagliflozin in patients with heart failure and reduced ejection fraction.
Dapagliflozin in patients with heart failure and reduced ejection fraction.
N Engl J Med. 2019; 381: 1995-2008
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Article info
Publication history
Published online: August 07, 2020
Received in revised form:
July 28,
2020
Received:
July 10,
2020
Footnotes
Conflicts of interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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