Management of heart failure and type 2 diabetes mellitus: Maximizing complementary drug therapy
- PMID: 32243706
- DOI: 10.1111/dom.14042
Management of heart failure and type 2 diabetes mellitus: Maximizing complementary drug therapy
Abstract
Type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular disease and occurs in ~25% of patients with heart failure (HF). Patients with co-morbid HF and T2DM are at elevated risk of adverse outcomes, making optimization of complementary drug therapies essential. While research is ongoing, recent advances in drug therapy, including the introduction of sacubitril/valsartan for HF with reduced ejection fraction and the finding of positive cardiovascular effects of glucose-lowering agents (particularly sodium-glucose co-transporter-2 [SGLT2] inhibitors) have the potential to transform pharmacologic management of co-morbid HF and T2DM. In this review, we provide a comprehensive overview of cardiovascular clinical trials of therapies for HF and diabetes mellitus to date and identify areas requiring further investigation. We also discuss the pathophysiologic overlap of the two diseases and explore the complementary therapeutic effects of HF and T2DM drugs, with a particular focus on sacubitril/valsartan and SGLT2 inhibitors.
Keywords: cardiovascular disease; heart failure; type 2 diabetes mellitus.
© 2020 John Wiley & Sons Ltd.
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References
REFERENCES
-
- Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62(16):e147-e239.
-
- Johansson I, Dahlstrom U, Edner M, Nasman P, Ryden L, Norhammar A. Type 2 diabetes and heart failure: characteristics and prognosis in preserved, mid-range and reduced ventricular function. Diab Vasc Dis Res. 2018;15(6):494-503.
-
- Mentz RJ, Kelly JP, von Lueder TG, et al. Noncardiac comorbidities in heart failure with reduced versus preserved ejection fraction. J Am Coll Cardiol. 2014;64(21):2281-2293.
-
- Dauriz M, Mantovani A, Bonapace S, et al. Prognostic impact of diabetes on long-term survival outcomes in patients with heart failure: a meta-analysis. Diabetes Care. 2017;40(11):1597-1605.
-
- Sandesara PB, OʼNeal WT, Kelli HM, et al. The prognostic significance of diabetes and microvascular complications in patients with heart failure with preserved ejection fraction. Diabetes Care. 2018;41(1):150-155.
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