Cornelius James Fernandez, Abisha Graciano Nevins, Shasta Nawaz, Tahir Nazir and Fahmy W.F. Hanna* Pages 178 - 196 ( 19 )
Patients with diabetes continued to exhibit a high risk for cardiovascular and renal events despite achieving satisfactory glycemic, blood pressure and lipid targets. Studies evaluating new diabetes medications focused on cardiovascular events, largely overlooking heart failure (HF). The latter has recently been recognised as a major cause of morbidity and mortality in patients with diabetes mellitus. There had been an unmet need for drugs with cardiovascular (including HF) and renal protection, with an expectation that an ideal diabetic drug should improve these endpoints. Moreover, an ideal drug should have weight reducing benefits. Recently published outcome trials have shown that sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1RAs) can reduce cardiovascular and renal events, together with statistically significant weight reduction. As a result, many recently published international guidelines have recommended SGLT2 inhibitors and GLP-1RAs in patients with diabetes and pre-existing cardiovascular disease (CVD). In this review, we will critically analyse the efficacy and cardiovascular (CV) safety of SGLT2 inhibitors, based on the available literature to help position them in the clinical decision process.
SGLT2 Inhibitors, diabetes mellitus, cardiovascular safety, efficacy, cardiovascular benefits, renal benefits.
Department of Endocrinology and Metabolism, Pilgrim Hospital, Boston, PE21 9QS, Department of Medicine, Blackpool Victoria Hospital, Blackpool, FY3 8NR, Department of Medicine and Endocrinology, Royal Preston Hospital, Preston, PR2 9HT, Department of Medicine, Royal Preston Hospital, Preston, PR2 9HT, Professor of Endocrinology and Metabolism, Staffordshire University/ University Hospitals of North Midlands, Preston, ST4 6QG