Cardiovascular and Renal Outcomes of Newer Anti-Diabetic Medications in High-Risk Patients

• Published in: Current cardiology reports Vol. 20; no. 8; p. 65
• Main Authors: Lawrence, Lima, Menon, Venu, Kashyap, Sangeeta
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-08-2018
• Subjects: Cardiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Cardiovascular Diseases - prevention & control; Cardiovascular System - drug effects; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Dipeptidyl-Peptidase IV Inhibitors - therapeutic use; Glucagon-Like Peptide 1 - agonists; Glucagon-Like Peptide 1 - therapeutic use; Humans; Hypoglycemic Agents - adverse effects; Ischemic Heart Disease (D Mukherjee; Kidney - drug effects; Medicine; Medicine & Public Health; Pioglitazone - therapeutic use; Randomized Controlled Trials as Topic; Risk Factors; Section Editor; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Topical Collection on Ischemic Heart Disease; IRIS; LEADER; Cardiovascular benefits; CANVAS; Diabetes medications; EMPA-REG
• ISSN: 1523-3782; 1534-3170
• DOI: 10.1007/s11886-018-1005-8

Purpose of Review
We review the cardiovascular and renal outcomes and safety of newer anti-diabetic medications in high-risk patients. We examine the outcomes of the IRIS, EMPA-REG OUTCOME, CANVAS, LEADER, SAVOR-TIMI 53, and EXAMINE trials demonstrating the cardiovascular and renal benefits of thiazolidinediones, SGLT2 inhibitors, GLP-1 agonists, and DPP-4 inhibitors.
Recent Findings
Diabetes mellitus is a leading risk factor for cardiovascular disease with rising prevalence and disease burden. The microvascular and macrovascular complications of diabetes are well-recognized and include increased risk of cardiovascular disease, myocardial infarction, and stroke. Newer diabetes medications have demonstrated significant cerebrovascular, cardiovascular, renal, and mortality benefits in high risk patients with diabetes. In addition to their glucose-lowering effects, the thiazolidinedione pioglitazone, SGLT2 inhibitors, GLP-1 agonist, and DPP-4 inhibitors have demonstrated significant cerebrovascular, cardiovascular, renal, and mortality effects.
Summary
The outcomes and safety data of newer diabetes medications from recent trials demonstrate cardiovascular and mortality effects with significant implications for clinical practice.