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Is There a Diabetes–Kidney–Heart Continuum? Perspectives From the Results of the Cardiovascular and Renal Outcome Clinical Trials With SGLT2 Inhibitors

Heart failure is associated with a substantial risk of mortality and morbidity. Findings from recent cardiovascular outcome trials have shown promise for sodium-glucose cotransporter-2 (SGLT2) inhibitors in preventing heart failure in patients with type 2 diabetes mellitus (T2DM). Notably, the benef...

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Autores principales: Bao, Liwen, Gao, Xiufang, Xie, Kun, Li, Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8494970/
https://www.ncbi.nlm.nih.gov/pubmed/34631819
http://dx.doi.org/10.3389/fcvm.2021.716083
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author Bao, Liwen
Gao, Xiufang
Xie, Kun
Li, Yong
author_facet Bao, Liwen
Gao, Xiufang
Xie, Kun
Li, Yong
author_sort Bao, Liwen
collection PubMed
description Heart failure is associated with a substantial risk of mortality and morbidity. Findings from recent cardiovascular outcome trials have shown promise for sodium-glucose cotransporter-2 (SGLT2) inhibitors in preventing heart failure in patients with type 2 diabetes mellitus (T2DM). Notably, the benefits of SGLT2 inhibitors were consistent despite the presence of risk factors like atherosclerosis. Increasing evidence suggests that SGLT2 inhibitors may confer their cardioprotective effects through multiple mechanisms, ranging from improving cardiac and vascular performance to metabolism. The reduction of heart failure risk by SGLT2 inhibitors may also be attributed to the preservation of renal function. Indeed, renal insufficiency is a frequent comorbidity of patients with heart failure and T2DM; hence, the natriuretic and kidney protective effects offered by SGLT2 inhibitors may contribute to limiting adverse cardiac outcomes. In this article, we discuss the latest findings from the cardiovascular and renal outcome trials, paying special attention to the interlink between heart and kidney function, and how effective treatment of heart failure—irrespective of T2DM diagnosis—may require agents that offer both cardiac and renal protection.
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spelling pubmed-84949702021-10-08 Is There a Diabetes–Kidney–Heart Continuum? Perspectives From the Results of the Cardiovascular and Renal Outcome Clinical Trials With SGLT2 Inhibitors Bao, Liwen Gao, Xiufang Xie, Kun Li, Yong Front Cardiovasc Med Cardiovascular Medicine Heart failure is associated with a substantial risk of mortality and morbidity. Findings from recent cardiovascular outcome trials have shown promise for sodium-glucose cotransporter-2 (SGLT2) inhibitors in preventing heart failure in patients with type 2 diabetes mellitus (T2DM). Notably, the benefits of SGLT2 inhibitors were consistent despite the presence of risk factors like atherosclerosis. Increasing evidence suggests that SGLT2 inhibitors may confer their cardioprotective effects through multiple mechanisms, ranging from improving cardiac and vascular performance to metabolism. The reduction of heart failure risk by SGLT2 inhibitors may also be attributed to the preservation of renal function. Indeed, renal insufficiency is a frequent comorbidity of patients with heart failure and T2DM; hence, the natriuretic and kidney protective effects offered by SGLT2 inhibitors may contribute to limiting adverse cardiac outcomes. In this article, we discuss the latest findings from the cardiovascular and renal outcome trials, paying special attention to the interlink between heart and kidney function, and how effective treatment of heart failure—irrespective of T2DM diagnosis—may require agents that offer both cardiac and renal protection. Frontiers Media S.A. 2021-09-23 /pmc/articles/PMC8494970/ /pubmed/34631819 http://dx.doi.org/10.3389/fcvm.2021.716083 Text en Copyright © 2021 Bao, Gao, Xie and Li. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Bao, Liwen
Gao, Xiufang
Xie, Kun
Li, Yong
Is There a Diabetes–Kidney–Heart Continuum? Perspectives From the Results of the Cardiovascular and Renal Outcome Clinical Trials With SGLT2 Inhibitors
title Is There a Diabetes–Kidney–Heart Continuum? Perspectives From the Results of the Cardiovascular and Renal Outcome Clinical Trials With SGLT2 Inhibitors
title_full Is There a Diabetes–Kidney–Heart Continuum? Perspectives From the Results of the Cardiovascular and Renal Outcome Clinical Trials With SGLT2 Inhibitors
title_fullStr Is There a Diabetes–Kidney–Heart Continuum? Perspectives From the Results of the Cardiovascular and Renal Outcome Clinical Trials With SGLT2 Inhibitors
title_full_unstemmed Is There a Diabetes–Kidney–Heart Continuum? Perspectives From the Results of the Cardiovascular and Renal Outcome Clinical Trials With SGLT2 Inhibitors
title_short Is There a Diabetes–Kidney–Heart Continuum? Perspectives From the Results of the Cardiovascular and Renal Outcome Clinical Trials With SGLT2 Inhibitors
title_sort is there a diabetes–kidney–heart continuum? perspectives from the results of the cardiovascular and renal outcome clinical trials with sglt2 inhibitors
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8494970/
https://www.ncbi.nlm.nih.gov/pubmed/34631819
http://dx.doi.org/10.3389/fcvm.2021.716083
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