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Exploration of the clinical benefits of sodium glucose co-transporter 2 inhibitors in diabetic patients with concomitant heart failure

Prevention and treatment strategies for heart failure (HF) in diabetes have not been fully established, at least partly due to lack of recognition of a pathological link between the two and effective antidiabetic agents for HF. Recent cardiovascular (CV) outcomes trials demonstrated that treatment w...

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Autores principales: Tanaka, Atsushi, Node, Koichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968589/
https://www.ncbi.nlm.nih.gov/pubmed/29801492
http://dx.doi.org/10.1186/s12933-018-0719-7
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author Tanaka, Atsushi
Node, Koichi
author_facet Tanaka, Atsushi
Node, Koichi
author_sort Tanaka, Atsushi
collection PubMed
description Prevention and treatment strategies for heart failure (HF) in diabetes have not been fully established, at least partly due to lack of recognition of a pathological link between the two and effective antidiabetic agents for HF. Recent cardiovascular (CV) outcomes trials demonstrated that treatment with sodium glucose co-transporter 2 (SGLT2) inhibitors greatly improved major CV adverse events in type 2 diabetes (T2D) patients at high risk for CV events, seemingly driven by risk reduction in HF-related outcomes. The beneficial effects of SGLT2 inhibitors on such outcomes and the heart itself are unique characteristics among antidiabetic agents, and SGLT2 inhibitors are expected to be a promising therapeutic option for CV disease and HF care. However, because a limited number of T2D patients with concomitant HF were included in the CV outcomes trials, the treatment effects of SGLT2 inhibitors for such conditions have not been fully investigated. Moreover, there has been little evidence to suggest SGLT2 inhibitor mediated effects on CV function and relevant biomarkers. Januzzi et al. (J Am Coll Cardiol 70: 704–712, 2017) reported that canagliflozin treatment could delay the escalation of cardiac biomarkers in older T2D patients, suggesting direct CV protection by SGLT2 inhibitors in this population. Whether SGLT2 inhibitors can exert similar benefits in T2D patients with concomitant HF will likely be the next big issue of medical concern. Furthermore, newer clinical trials are currently ongoing to investigate whether SGLT2 inhibitors exhibit beneficial effects for HF, both in the presence and absence of T2D. Such trials may potentially identify novel approaches for treating HF.
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spelling pubmed-59685892018-05-30 Exploration of the clinical benefits of sodium glucose co-transporter 2 inhibitors in diabetic patients with concomitant heart failure Tanaka, Atsushi Node, Koichi Cardiovasc Diabetol Commentary Prevention and treatment strategies for heart failure (HF) in diabetes have not been fully established, at least partly due to lack of recognition of a pathological link between the two and effective antidiabetic agents for HF. Recent cardiovascular (CV) outcomes trials demonstrated that treatment with sodium glucose co-transporter 2 (SGLT2) inhibitors greatly improved major CV adverse events in type 2 diabetes (T2D) patients at high risk for CV events, seemingly driven by risk reduction in HF-related outcomes. The beneficial effects of SGLT2 inhibitors on such outcomes and the heart itself are unique characteristics among antidiabetic agents, and SGLT2 inhibitors are expected to be a promising therapeutic option for CV disease and HF care. However, because a limited number of T2D patients with concomitant HF were included in the CV outcomes trials, the treatment effects of SGLT2 inhibitors for such conditions have not been fully investigated. Moreover, there has been little evidence to suggest SGLT2 inhibitor mediated effects on CV function and relevant biomarkers. Januzzi et al. (J Am Coll Cardiol 70: 704–712, 2017) reported that canagliflozin treatment could delay the escalation of cardiac biomarkers in older T2D patients, suggesting direct CV protection by SGLT2 inhibitors in this population. Whether SGLT2 inhibitors can exert similar benefits in T2D patients with concomitant HF will likely be the next big issue of medical concern. Furthermore, newer clinical trials are currently ongoing to investigate whether SGLT2 inhibitors exhibit beneficial effects for HF, both in the presence and absence of T2D. Such trials may potentially identify novel approaches for treating HF. BioMed Central 2018-05-25 /pmc/articles/PMC5968589/ /pubmed/29801492 http://dx.doi.org/10.1186/s12933-018-0719-7 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Commentary
Tanaka, Atsushi
Node, Koichi
Exploration of the clinical benefits of sodium glucose co-transporter 2 inhibitors in diabetic patients with concomitant heart failure
title Exploration of the clinical benefits of sodium glucose co-transporter 2 inhibitors in diabetic patients with concomitant heart failure
title_full Exploration of the clinical benefits of sodium glucose co-transporter 2 inhibitors in diabetic patients with concomitant heart failure
title_fullStr Exploration of the clinical benefits of sodium glucose co-transporter 2 inhibitors in diabetic patients with concomitant heart failure
title_full_unstemmed Exploration of the clinical benefits of sodium glucose co-transporter 2 inhibitors in diabetic patients with concomitant heart failure
title_short Exploration of the clinical benefits of sodium glucose co-transporter 2 inhibitors in diabetic patients with concomitant heart failure
title_sort exploration of the clinical benefits of sodium glucose co-transporter 2 inhibitors in diabetic patients with concomitant heart failure
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968589/
https://www.ncbi.nlm.nih.gov/pubmed/29801492
http://dx.doi.org/10.1186/s12933-018-0719-7
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