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Oral hypoglycemic agents and the heart failure conundrum: Lessons from and for outcome trials.

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Oral hypoglycemic agents and the heart failure conundrum: Lessons from and for outcome trials.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kappel, B. A. Marx, N. Federici, M.
Description	Country affiliation: Germany Author Affiliation: Kappel BA ( Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy); Marx N ( Department of Internal Medicine I, University Hospital Aachen, Germany.); Federici M ( Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy)
Abstract	AIM: Type 2 diabetes is not only an independent risk factor for cardiovascular (CV) disease but is also associated with a greater incidence of heart failure (HF). The aim of this review is to examine the effects of oral antidiabetic drugs on CV disease and HF. DATA SYNTHESIS: Trials of anti-diabetic agents are now designed to assess CV safety, but frequently HF is not included as a primary endpoint. However, HF in patients with diabetes is more frequent than other CV events and seems to be underestimated. A burning question is therefore if the most used trial design to monitor CV safety, i.e. non-inferiority, allows clinical translation of trial findings. Available data further suggest that the CV effects of anti-diabetic drugs may be rather class-specific and are only partly due to their glucose-lowering actions. Metformin, recommended as first line in most guidelines, shows positive CV effects while other classes like thiazolidinediones may precipitate HF. Experimental results on the relatively novel dipeptidyl peptidase IV (DPP IV) inhibitors imply CV protective effects, but the non-inferiority trials published to date show an overall neutral CV outcome and a potential increase in HF by saxagliptin. However, results on sitagliptin of the recently released TECOS indicate that HF is not a class-dependent effect of DPP IV inhibitors. CONCLUSION: Further basic research and long-term outcome studies to clarify the effects of antidiabetic agents on CV and HF are required so that we can select the optimal antidiabetic therapy for our patients.
File Format	HTM / HTML
ISSN	09394753
Issue Number	8
Volume Number	25
e-ISSN	15903729
Journal	Nutrition, Metabolism and Cardiovascular Diseases
Language	English
Publisher	Elsevier
Publisher Date	2015-08-01
Publisher Place	Netherlands
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Metabolism Discipline Cardiology Discipline Vascular Diseases Discipline Nutritional Sciences Blood Glucose Drug Effects Cardiovascular Diseases Chemically Induced Clinical Trials As Topic Diabetes Mellitus, Type 2 Drug Therapy Heart Failure Hypoglycemic Agents Adverse Effects Adamantane Analogs & Derivatives Administration, Oral Dipeptides Dipeptidyl-peptidase Iv Inhibitors Humans Administration & Dosage Therapeutic Use Metformin Risk Factors Sitagliptin Phosphate Thiazolidinediones Journal Article Research Support, Non-u.s. Gov't Review
Content Type	Text
Resource Type	Article
Subject	Nutrition and Dietetics Endocrinology, Diabetes and Metabolism Cardiology and Cardiovascular Medicine

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Az inkretintengelyen ható antidiabetikumokkal végzett cardiovascularis biztonságossági tanulmányok eddigi tapasztalatai.

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Az inkretintengelyen ható antidiabetikumokkal végzett cardiovascularis biztonságossági tanulmányok eddigi tapasztalatai.

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Oral hypoglycemic agents and the heart failure conundrum: Lessons from and for outcome trials.