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Curr Vasc Pharmacol. 2019 May 6. doi: 10.2174/1570161117666190426162746. [Epub ahead of print]

Pharmacological Management of Cardiac Disease in Patients with Type 2 Diabetes: Insights into Clinical Practice

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Second Propedeutic Department of Internal Medicine, General Hospital ``Hippokration``, Aristotle University of Thessaloniki, Thessaloniki, Greece



Type 2 diabetes (T2D) has emerged as a growing pandemic. Cardiovascular disease (CVD) constitutes another major health problem, with coronary heart disease being the leading cause of cardiovascular death. Patients with T2D require a multilevel therapeutic approach, both for primary and secondary prevention of CVD.


To present and summarize the most recent, highest level evidence retrieved from literature, relevant to the pharmaceutical management of CVD in T2D.


We conducted a comprehensive research of the literature, searching MEDLINE from its inception till 5thOctober 2018, primarily for relevant systematic reviews, meta-analyses and randomized controlled trials.


There is a trend towards more intensified therapeutic interventions in T2D, concerning glycemic, lipid and blood pressure control. New drugs, such as SGLT-2 inhibitors, GLP-1 agonists and PCKSK9 inhibitors might evolve as key players in the management of diabetes and its complications within the next years. Classic drugs, such as those targeting renin-angiotensin-aldosterone system, statins and aspirin remain first-line treatment options, both for primary and secondary prevention of CVD. Lifestyle interventions should always be integrated into a complete therapeutic strategy in diabetic patients. Novel drugs, such as finerenone, LCZ696 and canakinumab have provided significant results in cardiovascular outcome studies; however, their role in type 2 diabetes has to be further elucidated.


Pharmaceutical approach of CVD in T2D is multilevel and complex. Drug classes featuring pleiotropic effects may booster our armamentarium in the fight against CVD.


type 2 diabetes; cardiovascular disease; mortality; prevention

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