Predicting and preventing heart failure in type 2 diabetes
- PMID: 37385290
- DOI: 10.1016/S2213-8587(23)00128-6
Predicting and preventing heart failure in type 2 diabetes
Abstract
The burden of heart failure among people with type 2 diabetes is increasing globally. People with comorbid type 2 diabetes and heart failure often have worse outcomes than those with only one of these conditions-eg, higher hospitalisation and mortality rates. Therefore, it is essential to implement optimal heart failure prevention strategies for people with type 2 diabetes. A detailed understanding of the pathophysiology underlying the occurrence of heart failure in type 2 diabetes can aid clinicians in identifying relevant risk factors and lead to early interventions that can help prevent heart failure. In this Review, we discuss the pathophysiology and risk factors of heart failure in type 2 diabetes. We also review the risk assessment tools for predicting heart failure incidence in people with type 2 diabetes as well as the data from clinical trials that have assessed the efficacy of lifestyle and pharmacological interventions. Finally, we discuss the potential challenges in implementing new management approaches and offer pragmatic recommendations to help overcome these challenges.
Copyright © 2023 Elsevier Ltd. All rights reserved.
Conflict of interest statement
Declaration of interests AP has received research support from the National Institute on Aging (GEMSSTAR grant: 1R03AG067960-01) and the National Institute on Minority Health and Disparities (R01MD017529); grant funding from Applied Therapeutics and Gilead Sciences; has received honoraria outside of the present study as an advisor or consultant for Tricog Health, Eli Lilly, Rivus, Cytokinetics, and Roche Diagnostics; has received non-financial support from Pfizer and Merck; and is also a consultant for Palomarin with stocks compensation. KVP has served as a consultant to Novo Nordisk. DLB sits on the advisory board of Angiowave, Bayer, Boehringer Ingelheim, Cardax, CellProthera, Cereno Scientific, Elsevier Practice Update Cardiology, High Enroll, Janssen, Level Ex, McKinsey, Medscape Cardiology, Merck, MyoKardia, NirvaMed, Novo Nordisk, PhaseBio, PLx Pharma, Regado Biosciences, and Stasys; and on the board of directors of Angiowave (with stock options), Boston VA Research Institute, Bristol Myers Squibb (with stock), DRS.LINQ (with stock options), High Enroll (with stock), Society of Cardiovascular Patient Care, and TobeSoft. DLB was the inaugural chair of the American Heart Association Quality Oversight Committee. DLB is a consultant for Broadview Ventures and Hims; and sits on data monitoring committees for Acesion Pharma, Assistance Publique-Hôpitaux de Paris, Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute) for the PORTICO trial funded by St Jude Medical (now Abbott), Boston Scientific (chair for PEITHO trial), Cleveland Clinic (including for the ExCEED trial, funded by Edwards), Contego Medical (chair for PERFORMANCE 2), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine for the ENVISAGE trial funded by Daiichi Sankyo and for the ABILITY-DM trial funded by Concept Medical, Novartis, Population Health Research Institute, and Rutgers University for the National Institutes of Health-funded MINT Trial. DLB reports honoraria from the American College of Cardiology as Senior Associate Editor of Clinical Trials and News and chair of American College of Cardiology Accreditation Oversight Committee; Arnold and Porter law firm for work related to Sanofi–Bristol Myers Squibb clopidogrel litigation; Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute) for the RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim and AEGIS-II executive committee funded by CSL Behring; Belvoir Publications as Editor in Chief of Harvard Heart Letter; Canadian Medical and Surgical Knowledge Translation Research Group for clinical trial steering committees; Cowen and Company; Duke Clinical Research Institute for clinical trial steering committees, including for the PRONOUNCE trial, funded by Ferring Pharmaceuticals; HMP Global as Editor in Chief of the Journal of Invasive Cardiology; Journal of the American College of Cardiology as Guest Editor and Associate Editor; K2P as co-chair of interdisciplinary curriculum; Level Ex; Medtelligence–ReachMD for continuing medical education steering committees; MJH Life Sciences; Oakstone CME as Course Director of the Comprehensive Review of Interventional Cardiology; Piper Sandler; Population Health Research Institute for the COMPASS operations committee, publications committee, steering committee, and USA national co-leader, funded by Bayer; Slack Publications as Chief Medical Editor of Cardiology Intervention Today; Society of Cardiovascular Patient Care as secretary and treasurer; WebMD for continuing medical education steering committees; Wiley for steering committee. DLB reports non-financial relationships as Deputy Editor of Clinical Cardiology; as chair of the National Cardiovascular Data Registry–Acute Coronary Intervention and Outcomes Network Registry steering committee; as chair of the Veterans Affairs Cardiovascular Assessment, Reporting, and Tracking Research and publications committee. DLB reports a patent for sotagliflozin (named on a patent for sotagliflozin assigned to Brigham and Women's Hospital who assigned to Lexicon; however, neither DLB or Brigham and Women's Hospital receive any income from this patent). DLB reports research funding for Abbott, Acesion Pharma, Afimmune, Aker Biomarine, Amarin, Amgen, AstraZeneca, Bayer, Beren, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardax, CellProthera, Cereno Scientific, Chiesi, CinCor, Cleerly, CSL Behring, Eisai, Ethicon, Faraday Pharmaceuticals, Ferring Pharmaceuticals, Forest Laboratories, Fractyl, Garmin, HLS Therapeutics, Idorsia, Ironwood, Ischemix, Janssen, Javelin, Lexicon, Eli Lilly, Medtronic, Merck, Moderna, MyoKardia, NirvaMed, Novartis, Novo Nordisk, Owkin, Pfizer, PhaseBio, PLx Pharma, Recardio, Regeneron, Reid Hoffman Foundation, Roche, Sanofi, Stasys, Synaptic, The Medicines Company, Youngene, and 89Bio. DLB reports royalties from Elsevier as Editor of Braunwald's Heart Disease; as site co-investigator for Abbott, Biotronik, Boston Scientific, CSI, Endotronix, St Jude Medical (now Abbott), Philips, SpectraWAVE, Svelte, and Vascular Solutions; as trustee for the American College of Cardiology; and for unfunded research of FlowCo and Takeda. SV holds a Tier 1 Canada Research Chair in Cardiovascular Surgery; and reports receiving research grants or speaking honoraria from Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Canadian Medical, and Surgical Knowledge Translation Research Group, Eli Lilly, HLS Therapeutics, Janssen, Novartis, Novo Nordisk, Pfizer, PhaseBio, S & L Solutions Event Management, and Sanofi. SV is the President of the Canadian Medical and Surgical Knowledge Translation Research Group, a federally incorporated not-for-profit physician organisation. MSK declares no competing interests.
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