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Review
. 2019 Sep;34(5):578-583.
doi: 10.1097/HCO.0000000000000647.

Predictors of heart failure development in type 2 diabetes: a practical approach

Subodh Verma  1 , Abhinav Sharma  2 , Naresh Kanumilli  3 , Javed Butler  4
Affiliations
Review

Predictors of heart failure development in type 2 diabetes: a practical approach

Subodh Verma et al. Curr Opin Cardiol. 2019 Sep.

Abstract

Purpose of review: Although type 2 diabetes (T2D) is one of the most important risk factors that leads to the development of de novo heart failure, there are limited data, particularly from a practical/qualitative standpoint, about predictors of heart failure in this population.

Recent findings: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have been shown to prevent the development of heart failure and the composite of heart failure and cardiovascular death in patients with T2D without known heart failure who have either established atherosclerotic vascular disease or multiple risk factors. The concept of primary prevention of heart failure has led many clinicians to inquire if there are specific risk/enrichment factors that may predict an increased risk of heart failure.

Summary: In this review, we identify some general and diabetes-specific risk factors that are associated with an increased risk of developing heart failure in people with T2D.

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Figures

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FIGURE 1
FIGURE 1
Potential framework for identifying patients without baseline heart failure or established atherosclerotic cardiovascular disease who may benefit from sodium-glucose cotransporter-2 inhibitors. aSaxagliptin and alogliptin. bIncluding neuropathy, retinopathy, or nephropathy. ASCVD, atherosclerotic cardiovascular disease; HbA1c, glycated hemoglobin; NTproBNP, N-terminal probrain natriuretic peptide; SGLT-2, sodium-glucose cotransporter-2; TZD, thiazolidinedione.
See this image and copyright information in PMC

References

    1. Verma S, Jüni P, Mazer CD. Pump, pipes, and filter: do SGLT2 inhibitors cover it all? Lancet 2019; 393:3–5. - PubMed

    2. The article describes a novel paradigm for heart failure risk reduction among patients with type 2 diabetes (T2D).

    1. Rawshani A, Rawshani A, Franzén S, et al. Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2018; 379:633–644. - PubMed
    1. Sharma A, Cannon CP, White WB, et al. Early and chronic dipeptidyl-peptidase-IV inhibition and cardiovascular events in patients with type 2 diabetes mellitus after an acute coronary syndrome: a landmark analysis of the EXAMINE trial. J Am Heart Assoc 2018; 7:e007649. - PMC - PubMed
    1. Sharma A, Green JB, Dunning A, et al. Causes of death in a contemporary cohort of patients with type 2 diabetes and atherosclerotic cardiovascular disease: insights from the TECOS trial. Diabetes Care 2017; 40:1763–1770. - PubMed
    1. McMurray JJV, Gerstein HC, Holman RR, Pfeffer MA. Heart failure: a cardiovascular outcome in diabetes that can no longer be ignored. Lancet Diabetes Endocrinol 2014; 2:843–851. - PubMed

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