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J Am Coll Cardiol. 2018 Oct 9;72(15):1856-1869. doi: 10.1016/j.jacc.2018.07.071.

The Changing Landscape of Diabetes Therapy for Cardiovascular Risk Reduction: JACC State-of-the-Art Review.

Author information

1
Division of Cardiology and Center for the Prevention of Cardiovascular Disease, Department of Medicine, New York University Medical Center, New York, New York. Electronic address: Jonathan.Newman@nyumc.org.
2
Division of Cardiology and Center for the Prevention of Cardiovascular Disease, Department of Medicine, New York University Medical Center, New York, New York.
3
Division of Endocrinology, New York University Medical Center, New York, New York.

Abstract

Type 2 diabetes mellitus (T2D) is a major risk factor for cardiovascular disease (CVD), the most common cause of death in T2D. Despite improved risk factor control, however, adults with T2D continue to experience substantial excess CVD risk. Until recently, however, improved glycemic control has not been associated with robust macrovascular benefit. The advent of 2 new classes of antihyperglycemic agents, the sodium-glucose cotransporter-2 inhibitors and the glucagon-like peptide-1 receptor agonists, and their respective large cardiovascular outcome trials, has led to a paradigm shift in how cardiologists and heath care practitioners conceptualize T2D treatment. Herein, the authors review the recent trial evidence, the potential mechanisms of action of the sodium-glucose cotransporter-2 inhibitors and the glucagon-like peptide-1 receptor agonists, safety concerns, and their use for the primary prevention of CVD as well as in diabetic patients with impaired renal function and heart failure.

KEYWORDS:

antidiabetic therapy; cardiovascular disease; primary prevention; secondary prevention; type 2 diabetes

PMID:
30286929
PMCID:
PMC6178226
[Available on 2019-10-09]
DOI:
10.1016/j.jacc.2018.07.071

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