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Cardiovascular Effects of Non-insulin Glucose-lowering Agents: a Comprehensive Review of Trial Evidence and Potential Cardioprotective Mechanisms by Gianluigi Savarese; Javed Butler; Lars H Lund; Deepak L Bhatt; Stefan D Anker is a Medicine article available to read on EtoBox.

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## Abstract Type 2 diabetes mellitus (T2DM) is highly prevalent and associated with a two-fold increased mortality, mostly explained by cardiovascular diseases. Trial evidence on older glucose-lowering agents such as metformin and sulfonylureas is limited in terms of cardiovascular efficacy. Since 2008, after rosiglitazone was observed to increase the risk of myocardial infarction and heart failure (HF), cardiovascular outcome trials (CVOTs) have been required by regulators for licensing new glucose-lowering agents. In the following CVOTs, dipeptidyl peptidase 4 inhibitors (DPP4i) have been shown to be safe but not to improve mortality/morbidity, except for saxagliptin which increased the risk of HF. Several glucagon-like peptide-1 receptor agonists (GLP1-Ra) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been demonstrated to reduce the risk of cardiovascular mortality and morbidity. SGLT2i have shown a class effect for the reduction in risk of HF events in patients with T2DM, leading to trials testing their efficacy/safety in HF regardless of T2DM. In the DAPA-HF and the EMPEROR-Reduced trials dapagliflozin and empagliflozin, respectively, improved cardiovascular mort

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Author

Gianluigi Savarese; Javed Butler; Lars H Lund; Deepak L Bhatt; Stefan D Anker

Publisher

Oxford University Press (OUP)

Published

2021

Language

EN

Field

Medicine (Health Sciences)