Heart failure in diabetes: effects of anti-hyperglycaemic drug therapy

Summary Individuals with diabetes are not only at high risk of developing heart failure but are also at increased risk of dying from it. Fortunately, antiheart failure therapies such as angiotensin-converting-enzyme inhibitors, β blockers and mineralocorticoid-receptor antagonists work similarly wel...

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Bibliographic Details
Published in:The Lancet (British edition) 2015-05, Vol.385 (9982), p.2107-2117
Main Authors: Gilbert, Richard E, Prof, Krum, Henry, Prof
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Aged, 80 and over
Cardiomyopathy
Cardiovascular disease
Clinical trials
Diabetes
Diabetes Mellitus, Type 2 - drug therapy
Diabetic Cardiomyopathies - chemically induced
Diabetic retinopathy
Dipeptidyl-Peptidase IV Inhibitors - adverse effects
Drug therapy
Enzyme inhibitors
Glucagon-Like Peptide 1 - adverse effects
Glucose
Glycoside Hydrolase Inhibitors - adverse effects
Heart attacks
Heart failure
Heart Failure - chemically induced
Humans
Hypertension
Hypoglycemic Agents - adverse effects
Insulin - adverse effects
Internal Medicine
Medical prognosis
Middle Aged
Mortality
Observational Studies as Topic
Pathogenesis
Randomized Controlled Trials as Topic
Sodium-Glucose Transporter 2 - antagonists & inhibitors
Stroke
Studies
Sulfonylurea Compounds - adverse effects
Thiazolidinediones - adverse effects
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Summary:Summary Individuals with diabetes are not only at high risk of developing heart failure but are also at increased risk of dying from it. Fortunately, antiheart failure therapies such as angiotensin-converting-enzyme inhibitors, β blockers and mineralocorticoid-receptor antagonists work similarly well in individuals with diabetes as in individuals without the disease. Response to intensive glycaemic control and the various classes of antihyperglycaemic agent therapy is substantially less well understood. Insulin, for example, induces sodium retention and thiazolidinediones increase the risk of heart failure. The need for new glucose-lowering drugs to show cardiovascular safety has led to the unexpected finding of an increase in the risk of admission to hospital for heart failure in patients treated with the dipeptidylpeptidase-4 (DPP4) inhibitor, saxagliptin, compared with placebo. Here we review the relation between glycaemic control and heart failure risk, focusing on the state of knowledge for the various types of antihyperglycaemic drugs that are used at present.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(14)61402-1