Cardiorenal syndrome and gliflozins


Authors: Alena Šmahelová
Authors‘ workplace: III. interní gerontometabolická klinika LF UK a FN Hradec Králové
Published in: Forum Diab 2019; 8(3): 174-177
Category:

Inhibitory SGLT2 – glifoziny – jsou novou skupinou antidiabetik, jejichž účinek není závislý na inzulinu. Velké randomizované klinické studie s dapagliflozinem, empagliflozinem a kanagliflozinem nejen potvrdily jejich kardiovaskulární bezpečnost, ale prokázaly i řadu významných benefitů.

Overview

SGLT2 inhibitors – gliflozins – are a new class of antidiabetic agents whose effect is not insulin dependent. Large randomized clinical trials with dapagliflozin, empagliflozin and canagliflozin have not only confirmed their cardiovascular safety, but have also shown a number of significant benefits. At present also their importance in primary prevention of cardiorenal disorders and the change of their position in current recommendations for the treatment of type 2 diabetes are emphasized. Therefore their early inclusion in the treatment of type 2 diabetic patients is important as they are more likely to have problems with cardiorenal syndrome, atherosclerotic cardiovascular disease, renal impairment and an increased risk of heart failure.

Keywords:

cardiorenal syndrome – clinical studies – gliflozins – type 2 diabetes


Sources
  1. Einarson TR, Acs A, Ludwig C et al. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol 2018; 17(1): 83. Dostupné z DOI: <http://dx.doi.org/10.1186/s12933-018-0728-6>.
  2. Ronco C, Haapio M, House AA et al. Cardiorenal syndrome.J Am Coll Cardiol 2008; 52(19): 1527-1539. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2008.07.051>.
  3. Dalrymple LS, Katz R, Kestenbaum B et al.Chronic kidney disease and the risk of end-stage renal disease versus death J Gen Intern Med 2011; 26(4): 379-385. Dostupné z DOI: <http://dx.doi.org/10.1007/s11606-010-1511-x>.
  4. Raz I, Mosenzon O, Bonaca MP et al. DECLARETIMI 58: Participants’ baseline characteristics. Diabetes Obes Metab 2018; 20(5): 1102–1120. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.13217>.
  5. Zelniker TA, Wiviott SD, Raz I et al. SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials.Lancet. 2019; 393(10166): 31-39. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140-6736(18)32590-X>.
  6. Wanner C, Inzucchi SC, Lachin JM et al. Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. N Engl J Med 2016; 375(4): 323-334. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1515920>.
  7. Neal B, Perkovic V, Mahaffey KW et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med 2017; 377(7): 644-657. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1611925>.
  8. McMurray JJV, DeMets DL, Inzucchi SE et al. A trial to evaluate the effect of the sodium-glucose co-transporter 2 inhibitor dapagliflozin on morbidity and mortality in patients with heart failure and reduced left ventricular ejection fraction (DAPA-HF). Eur J Heart Fail 2019; 21(5): 665-675. Dostupné z DOI: <http://dx.doi.org/10.1002/ejhf.1432>.
  9. McMurray J. Presentation at European Society of Cardiology Congress. September 1, 2019; Paris, France (ústní sdělení).
  10. [American Diabetes Association]. 8. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2018. Diabetes Care 2018;41(Suppl 1): S73–S85. Dostupné z DOI: <http://dx.doi.org/10.2337/dc18-S008>.
  11. Verma S, Jüni P, Mazer D. Pump, pipes, and filter: do SGLT2 inhibitors cover it all? Lancet 2019; 393(10166):3-5. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140-6736(18)32824-1>.
  12. Kosiborod M, Cavender MA, Fu AZ et al. [CVD-REAL Investigators and Study Group]. Lower Risk of Heart Failure and Death in Patients Initiated on Sodium-Glucose Cotransporter-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL Study (Comparative Effectiveness of Cardiovascular Outcomes in New Users of Sodium-Glucose Cotransporter-2 Inhibitors). Circulation 2017; 136(3): 249–259. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.117.029190>.
  13. The National Kidney Foundation – Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. 2007. Dostupné z: <https://kidneyfoundation.cachefly.net/professionals/KDOQI/guideline_diabetes/background.htm>
Labels
Diabetology Endocrinology Internal medicine Cardiology
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account