Τίτλος:
Update on cardiovascular effects of older and newer anti-diabetic medications
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
It is known that Cardiovascular (CV) disease is the leading cause of morbidity and mortality in individuals with type 2 diabetes. Over the last years, one of the most discussed topics is the CV safety of anti-diabetic medications. Regarding CV safety of older antidiabetic agents the data are less clear and conclusions about their CV safety are mostly based on randomized controlled trials designed to assess their glucose lowering efficacy. In this review, we summarize the current knowledge about the CV safety of older and newer antidiabetic medications. According to the published literature metformin is the first line agent for the treatment of type 2 diabetes and seems to have cardio-protective effects. The choice of the second line agent when metformin monotherapy fails to achieve HbA1c targets is less clear. In the light of the findings of the EMPA-REG OUTCOME trial and the recently published LEADER and SUSTAIN 6 trials, empagliflozin, liraglutide and semaglutide seem reasonable options as second line agents for patients with CV disease. Sulfonylureas on the other hand, with the exception of gliclazide, should be avoided in those patients, although CV safety trials are still lacking. In individuals without CV disease any of the other classes of anti-diabetic medication can be selected on a patient-centered approach. Saxagliptin, alogliptin, sitagliptin and lixisenatide have been evaluated in CV safety trials and have neutral effects on CV outcomes, while pioglitazone may have some CV benefits. Saxagliptin and alogliptin, however, should be avoided in patients with heart failure, while pioglitazone is contraindicated in this population. © 2018 Bentham Science Publishers.
Συγγραφείς:
Eleftheriadou, I.
Grigoropoulou, P.
Liberopoulos, E.
Liatis, S.
Kokkinos, A.
Tentolouris, N.
Περιοδικό:
Current Medicinal Chemistry
Εκδότης:
Bentham Science Publishers B.V.
Λέξεις-κλειδιά:
2,4 thiazolidinedione derivative; alpha glucosidase inhibitor; antidiabetic agent; dipeptidyl peptidase IV inhibitor; glucagon like peptide 1 receptor agonist; hemoglobin A1c; insulin; meglitinide; metformin; sodium glucose cotransporter 2 inhibitor; sulfonylurea derivative; antidiabetic agent; benzhydryl derivative; dipeptidyl peptidase IV inhibitor; empagliflozin; glucagon like peptide; glucoside; insulin; liraglutide; metformin; pioglitazone; semaglutide; sodium glucose cotransporter 2, all cause mortality; blood glucose monitoring; cardiovascular effect; cardiovascular mortality; drug safety; human; non insulin dependent diabetes mellitus; outcome assessment; Review; systematic review; cardiovascular disease; complication; glucose blood level; metabolism; non insulin dependent diabetes mellitus, Benzhydryl Compounds; Blood Glucose; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Dipeptidyl-Peptidase IV Inhibitors; Glucagon-Like Peptides; Glucosides; Humans; Hypoglycemic Agents; Insulin; Liraglutide; Metformin; Pioglitazone; Sodium-Glucose Transporter 2
DOI:
10.2174/0929867324666170530075533
