Abstract
Heart failure (HF) is common in Type-2 diabetes mellitus (T2DM), and viceversa, leading
to a mutual impact on prognosis. Knowledge about this complex interplay has dramatically
changed recently, due to development of new glucose-lowering drugs, and to specific
FDA and EMA Guidance mandating to perform cardiovascular outcome trials (CVOTs), aimed
at establishing cardiovascular safety, for new anti-diabetic treatments before they
enter the market.
Such CVOTs have demonstrated that the effects of the new antidiabetic drugs on the
mutual interactions between T2DM and HF may develop across different phases:
- -BEFORE HF ONSET (PRIMARY PREVENTION): evidence of benefit in preventing HF in T2DM (direct data)
- -WHEN HF IS ALREADY PRESENT (SECONDARY PREVENTION): evidence of benefits in T2DM patients with HF (subgroup analysis data).
These CVOTs data have led to guideline recommendations indicating appropriate therapy
to T2DM patients with HF not at glycemic control target with metformin therapy.
Keywords
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Article info
Publication history
Published online: August 31, 2019
Accepted:
July 30,
2019
Received:
July 27,
2019
Identification
Copyright
© 2019 Published by Elsevier B.V.
