New Antidiabetes Medications and Their Cardiovascular and Renal Benefits

Enrico G Ferro; Mohamed B Elshazly; Deepak L Bhatt

doi:10.1016/j.ccl.2021.04.007

New Antidiabetes Medications and Their Cardiovascular and Renal Benefits

Cardiol Clin. 2021 Aug;39(3):335-351. doi: 10.1016/j.ccl.2021.04.007.

Authors

Enrico G Ferro¹, Mohamed B Elshazly², Deepak L Bhatt³

Affiliations

¹ Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. Electronic address: https://twitter.com/DLBhattMD.
² Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, 601 North Caroline Street, Suite 7200, Baltimore, MD 21287, USA; Division of Cardiology, Department of Medicine, Weill Cornell Medical College-Qatar, Education City, PO Box 24144, Doha, Qatar.
³ Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Division of Cardiovascular Medicine, Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. Electronic address: DLBhattMD@post.Harvard.edu.

PMID: 34247748
DOI: 10.1016/j.ccl.2021.04.007

Abstract

After 12 years of rigorous cardiovascular outcome trials (CVOTs), sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) emerged as new therapeutic options for patients with type 2 diabetes mellitus to reduce the risk of heart disease. SGLT2i additionally cause a reduction in heart failure and renal events in patients both with and without diabetes. This article reviews the major CVOTs that support the use of these agents, describes the mechanisms of action that lead to their broad cardiorenal benefits, explains current guidelines, and offers practical clinical advice to initiate and monitor treatment with these agents.

Keywords: Cardiovascular outcome trials; Chronic kidney disease; Glucagon-like peptide-1 receptor agonists (GLP-1 RAs); Heart failure; Sodium-glucose cotransporter-2 inhibitors (SGLT2i).

Publication types

Review

MeSH terms

Cardiovascular Diseases* / drug therapy
Cardiovascular Diseases* / epidemiology
Cardiovascular Diseases* / prevention & control
Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / drug therapy
Glucagon-Like Peptide-1 Receptor
Humans
Hypoglycemic Agents / therapeutic use
Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use

Substances

Glucagon-Like Peptide-1 Receptor
Hypoglycemic Agents
Sodium-Glucose Transporter 2 Inhibitors