Cor Vasa 2019, 61(6):588-598 | DOI: 10.33678/cor.2019.008

(New antidiabetics and cardiovascular safety in the light of clinical trials)

Markéta Ječmenová^a, Jan Václavík^b, Miloš Táborský^b

^a InterMedCare s.r.o., Brno

^b I. interní klinika - kardiologická, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice Olomouc, Olomouc

Diabetes mellitus type 2 is a metabolic disease increasing cardiovascular risk. At the same time, the patients with type 2 diabetes are at a greater risk of cardiovascular events, heart failure and chronic renal disease. This review summarizes clinical trials from UKPDS, DCCT and ACCORD till the most recent trials for the new antidiabetics focused on a cardiovascular safety - DPP4 inhibitors, SGLT2 inhibitors and GLP-1 analogues. The overview discusses the particular cardiovascular outcomes, comorbidities and potential renal benefits from the treatment. All new antidiabetic agents were non-inferior with respect to primary cardiovascular outcome, thus proved the cardiovascular safety. Moreover, some of the latest studies with GLP-1 agonists and SGLT2 inhibitors proved cardiovascular protectivity and led to a lower rate of cardiovascular events. These findings resulted in changes in the Guidelines of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). The SGLT2 inhibitors and GLP-1 agonists should be preferred in the group of patients with type 2 diabetes with established cardiovascular or renal disease with respect to new evidence.

Keywords: Cardiovascular events, Cardiovascular safety, DPP4 inhibitors, Gliflozines, Gliptins, Heart failure, Myocardial infarction, Renal safety

Received: February 4, 2019; Accepted: March 5, 2019; Published: December 15, 2019  Show citation