Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2016, 25(5):384-388

An approach to the management of cardiovascular risk in diabetic patients - where are we in 2016?

Murín J1, Mikla F1, Wawruch M2, Kiňová S1
1 I. interná klinika LFUK a UN Bratislava
2 Ústav farmakológie a klinickej farmakológie LFUK a UN Bratislava, Slovenská republika

Type 2 diabetic patients have about a two times higher cardiovascular risk than non-diabetic persons. The UKPDS study showed us that strict glycaemic control in diabetic persons only reduces micro­ vascular events during the 10 years of treatment, but during the next 10 years of treatment there is also a reduction in macrovascular events. Other studies have shown similar results, but statistically non-significant (ADVANCE, VADT), though the ACCORD study showed more cardiovascular events in diabetics under strict glycaemic control. Also in the rosiglitazone study there was an increase of heart failure events in the rosiglitazone arm of treatment. Therefore the regulatory bodies in Europe (EMA) and in the USA (FDA), regarding the admission of new pharmaceutical products to these markets, have for some years now asked, for a new antidiabetic drug, with the existence of a clinical study showing us that this drug is cardiovasculary safe (non-inferior to a standard antidiabetic treatment). In the last two years two studies have showed us unexpectedly excellent results: the empagliflozine (EMPA-REG OUTCOMES study) reduced heart failure events (influencing hemodynamics), and the liraglutide (LEADER study) reduced cardiovascular events (by reduction of atherogenesis). Diabetic patients, who are also at high cardiovascular risk, now have better drugs for their treatment.

Keywords: diabetes mellitus type 2; cardiovascular diseases; antidiabetic drugs; empagliflozine; liraglutide

Published: May 1, 2016  Show citation

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Murín J, Mikla F, Wawruch M, Kiňová S. An approach to the management of cardiovascular risk in diabetic patients - where are we in 2016? Cardiology Letters. 2016;25(5):384-388.
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