Use of SGLT2 inhibitors vs GLP-1-receptor-agonists was associated with a similar risk of heart failure and lower risk of serious renal events while use of GLP-1-receptor-agonists vs SGLT2 inhibitors was associated with a slightly lower risk of MACE. In as-treated analyses, the associations with MACE and serious renal events increased in magnitude and the HR for heart failure tended towards a protective association for SGLT2 inhibitors (Diabetes, Obesity and Metabolism)
Diabetes News
Category: Cardiovascular
Heart failure in type 2 diabetes: current perspectives on screening, diagnosis and management
The aim of the review is to highlight the current perspectives of the pathophysiology of heart failure as it pertains to type 2 diabetes (Cardiovascular Diabetology)
Jardiance® shows consistent cardio-renal benefits in adults with heart failure with left ventricular ejection fraction over 40% regardless of chronic kidney disease status
In a new sub-analysis of the landmark EMPEROR-Preserved® phase III trial, Jardiance reduced the combined relative risk of cardiovascular death and hospitalization for heart failure and slowed kidney function decline (Boehringer Ingelheim and Eli Lilly)
The SGLT2 inhibitor dapagliflozin in heart failure with preserved ejection fraction: a multicenter randomized trial
These results indicate that 12 weeks of dapagliflozin treatment significantly improved patient-reported symptoms, physical limitations and exercise function and was well tolerated in chronic HFpE (Nature Medicine)
Differences in outcomes of hospitalizations for heart failure after SGLT2 inhibitor treatment: effect modification by atherosclerotic cardiovascular disease
In this study, history of established ASCVD was associated with different hHF risks among SGLT2 inhibitors. For T2D patients without ASCVD, dapagliflozin may offer a more favorable hHF reduction effect, compared to empagliflozin, in clinical practice. Future prospective studies should be conducted to validate our findings (Cardiovascular Diabetology)
Incidence Rates and Predictors of Microvascular and Macrovascular Complications in Patients with Type 2 Diabetes: Results from the Longitudinal Global DISCOVER Study
In this global study, both the prevalence and 3-year incidence of vascular complications were high in patients with relatively short T2D duration, highlighting the need for early risk-factor modification (American Heart Journal)
Optimal glucose, HbA1c, glucose-HbA1c ratio and stress-hyperglycaemia ratio cut-off values for predicting 1-year mortality in diabetic and non-diabetic acute myocardial infarction patients
SHR was the most consistent independent predictor of 1-year all-cause mortality in both diabetic and non-diabetic STEMI, whereas glucose was the best predictor in NSTEMI patients (Cardiovascular Diabetology)
Empagliflozin Treatment is Associated With Improvements in Cardiac Energetics and Function and Reductions in Myocardial Cellular Volume in Patients With Type 2 Diabetes
Empagliflozin thus ameliorates the ‘cardiac energy-deficient’ state, regresses adverse myocardial cellular remodelling, and improves cardiac function, offering therapeutic opportunities to prevent or modulate heart failure in T2D (Diabetes)
GLP-1 receptor agonists vs. SGLT-2 inhibitors: the gap seems to be leveling off
Overall, the results of CVOTs published so far seems to suggest that the gap between the cardiorenal benefits of SGLT-2 and GLP-1RA is narrowing (Cardiovascular Diabetology)
Estimated glucose disposal rate and risk of stroke and mortality in type 2 diabetes: a nationwide cohort study
A low eGDR (a measure of insulin resistance) is associated with an increased risk of stroke and death in individuals with T2D. The relative attributed risk was most important for hypertension (Cardiovascular Diabetology)
Empagliflozin protects the heart against ischemia/reperfusion-induced sudden cardiac death
Pretreatment with empagliflozin protects the heart from subsequent severe lethal ventricular arrhythmia induced by myocardial ischemia and reperfusion injury. These protective benefits may occur as a consequence of activation of the ERK1/2-dependent cell-survival signaling pathway in a glucose-independent manner (Cardiovascular Diabetology)
A Novel Hypothesis Linking Low Grade Ketonemia to Cardio-Renal Benefits with SGLT2-Inhibitors
In this review, we propose a novel hypothesis to link the pleiotropic effects of low grade ketonemia to the cardio-renal benefits seen with the SGLT2-inhibitors (Diabetes, Obesity and Metabolism)
Epidemiological Research Advances in Vascular Calcification in Diabetes
Because basic research on the clinical transformation of vascular calcification has yet to be conducted, this study systematically expounds on the risk factors for vascular calcification, vascular bed differences, sex differences, ethnic differences, diagnosis, severity assessments, and treatments to facilitate the identification of a new entry point for basic research and subsequent clinical transformation regarding vascular calcification and corresponding clinical evaluation strategies (Journal of Diabetes Research)
Sodium–Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists and the Risk for Cardiovascular Outcomes in Routine Care Patients With Diabetes Across Categories of Cardiovascular Disease
Use of SGLT2 inhibitors versus GLP-1 RAs was associated with consistent reductions in HHF risk among T2D patients with and without CVD, although the absolute benefit was greater in patients with CVD. There were no large differences in risk for MI or stroke among T2D patients with and without CVD (Annals of Internal Medicine)
Impact of prediabetes on long-term cardiovascular outcomes in patients with myocardial infarction with nonobstructive coronary arteries
Pre-DM defined as raised HbA1c was associated with a poor prognosis in patients with MINOCA. Routine assessment of HbA1c enables an early recognition of pre-DM and thus may facilitate risk stratification in this specific population (Diabetology & Metabolic Syndrome)
Hypofibrinolysis in type 2 diabetes and its clinical implications: from mechanisms to pharmacological modulation
This review presents the current data on the mechanisms underlying arterial and venous thrombotic complications in T2DM patients, with an emphasis on hypofibrinolysis and its impact on clinical outcomes (Cardiovascular Diabetology)
Longitudinal changes in vascular stiffness and heart rate variability among young adults with youth-onset type 2 diabetes
Results from the follow-up observational treatment options for type 2 diabetes in adolescents and youth (TODAY) study (Acta Diabetologica)
Basement membrane proteins in various arterial beds from individuals with and without type 2 diabetes mellitus: a proteome study
Our results suggest that accumulation of BM proteins is a general phenomenon in the medial layer of non-atherosclerotic arteries in patients with T2DM. Moreover, we identify additional T2DM-associated effects on the arterial proteome, which requires validation in future studies (Cardiovascular Diabetology)
Effects of Empagliflozin on Insulin Initiation or Intensification in Patients with Type 2 Diabetes and Cardiovascular Disease: Findings from the EMPA-REG OUTCOME® Trial
In patients with type 2 diabetes and cardiovascular disease, empagliflozin markedly and durably delays insulin initiation and substantial increases in insulin dose while facilitating sustained reductions in insulin requirements over time (Diabetes, Obesity and Metabolism)
Empagliflozin in Heart Failure with a Preserved Ejection Fraction
Empagliflozin reduced the combined risk of cardiovascular death or hospitalization for heart failure in patients with heart failure and a preserved ejection fraction, regardless of the presence or absence of diabetes (NEJM)
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