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Editorial
. 2020 Mar 19;19(1):35.
doi: 10.1186/s12933-020-01010-x.

Preventing major adverse cardiovascular events by SGLT-2 inhibition in patients with type 2 diabetes: the role of kidney

Dario Giugliano  1 , Luca De Nicola  2 , Maria Ida Maiorino  3 , Giuseppe Bellastella  4 , Carlo Garofalo  2 , Paolo Chiodini  5 , Antonio Ceriello  6 , Katherine Esposito  3
Affiliations
Editorial

Preventing major adverse cardiovascular events by SGLT-2 inhibition in patients with type 2 diabetes: the role of kidney

Dario Giugliano et al. Cardiovasc Diabetol. .

Abstract

Cardiovascular outcome trials (CVOTs) have demonstrated a significant reduction of major adverse cardiovascular events (MACE) in patients with type 2 diabetes (T2D) treated by SGLT-2 inhibitors. This holds true in the presence of background therapy with statins in most patients. Noteworthy, this SGLT-2 inhibitors effect is unique because, at variance with other components of cardiorenal protection, MACE prevention does not appear to be a class effect. Here, we present meta-analysis of the four key CVOTs indicating a major role of renal function in determining the extent of MACE prevention, with the benefit increasing in more severe kidney disease, that is, a high-risk condition where effectiveness of the traditional approach with statins is reduced.

Keywords: Diabetic kidney disease; MACE; SGLT-2 inhibitors; Statin therapy; Type 2 diabetes.

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Conflict of interest statement

D G. has been an advisory board member for and/or has received speaker’s fees from Eli Lilly, Boehringer Ingelheim, Novo Nordisk, Novartis, Mundipharma and Sanofi. L.D.N. has been an advisory board member for and/or has received speaker’s fees from Abiogen, Astellas, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Mundipharma and Vifor. M.I.M. received honoraria for speaking at meetings from Astra-Zeneca, Novo Nordisk, Bruno, Mundi Pharma, Merck. G.B. received honoraria for speaking at meetings for Roche and Novo Nordisk. A. C. has been an advisory board member for Abbott, Astra Zeneca, Boehringer Ingelheim, DOC Generici, Eli Lilly, Janssen, Mundipharma, Novo Nordisk and OM Pharma; has given lectures for Astra Zeneca, Berlin Chemie, Boehringer Ingelheim, Eli Lilly, Mundipharma, Novo Nordisk and Roche Diagnostics; and has received research grants from Astra Zeneca, Eli Lilly, Mitsubishi and Novartis. K. E. has been an advisory board member for and/or has received speaker’s fees from Eli Lilly, Boehringer Ingelheim, Novo Nordisk, Novartis, Mundipharma, Sanofi, Bruno Farmaceutici, Abbott, Lifescan, Roche. P.C., C.G., and G.B. declare they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Effect of SGLT-2 inhibitors on risk of MACE in the four CVOTs with gliflozins
Fig. 2
Fig. 2
Random-effect meta-analysis describing the effect of the four CVOTs with gliflozins on the primary endpoint (MACE) according to the renal function of patients with T2D
See this image and copyright information in PMC

References

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