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Review
. 2018 May;23(3):377-388.
doi: 10.1007/s10741-018-9674-3.

Possible mechanisms of direct cardiovascular impact of GLP-1 agonists and DPP4 inhibitors

Vasiliki Bistola  1 , Vaia Lambadiari  2 , George Dimitriadis  2 , Ioannis Ioannidis  3 , Konstantinos Makrilakis  4 , Nikolaos Tentolouris  4 , Apostolos Tsapas  5 , John Parissis  6
Affiliations
Review

Possible mechanisms of direct cardiovascular impact of GLP-1 agonists and DPP4 inhibitors

Vasiliki Bistola et al. Heart Fail Rev. 2018 May.

Abstract

Diabetes mellitus is a leading cause of cardiovascular morbidity and mortality worldwide. Traditional antidiabetic therapies targeting hyperglycemia reduce diabetic microvascular complications but have minor effects on macrovascular complications, including cardiovascular disease. Instead, cardiovascular complications are improved by antidiabetic medications (metformin) and other therapies (statins, antihypertensive medications) ameliorating insulin resistance and other associated metabolic abnormalities. Novel classes of antidiabetic drugs have proven efficacious in improving glycemia, while at the same time exert beneficial effects on pathophysiologic mechanisms of diabetes-related cardiovascular disease. In the present review, we will present current evidence of the cardiovascular effects of two new classes of antidiabetic medications, glucagon-like peptide 1 (GLP-1) agonists and dipeptidyl peptidase-4 (DPP4) inhibitors, focusing from mechanistic preclinical and clinical investigation to late-phase clinical testing.

Keywords: Cardiovascular outcomes; DPP4 inhibitors; GLP-1 agonists; New antidiabetic drugs; Type 2 diabetes mellitus.

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