Review of Cardiovascular Effects of Antidiabetic Drugs and Recent Cardiovascular Outcome Trials.

Kim,  So Hun

doi:2016.17.1.1

J Korean Diabetes > Volume 17(1); 2016 > Article

Opinion

The Journal of Korean Diabetes 2016;17(1):1-5.
DOI: https://doi.org/10.4093/jkd.2016.17.1.1 Published online April 12, 2016.

당뇨병 약제들의 심혈관계 효과와 그와 관련된 대규모 임상연구에 대한 고찰

김소헌

Review of Cardiovascular Effects of Antidiabetic Drugs and Recent Cardiovascular Outcome Trials.

So Hun Kim

Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea. shoney@inha.ac.kr

Abstract

Cardiovascular disease is a major cause of morbidity and mortality in people with type 2 diabetes. Therefore, the prevention of cardiovascular diseases is of great importance in these patients. Antidiabetic drugs may have cardiovascular effects independent of their glycemic effects. The highly publicized meta-analysis of rosiglitazone has triggered much concern about the cardiovascular effects of antidiabetic drugs. Since 2008, the US Food and Drug Administration (FDA) has required that all new antidiabetic drugs show proof of an acceptable cardiovascular risk profile. Because there is a lack of well-designed definitive studies, the cardiovascular risk/benefit is not definite in many drugs. Large randomized trials assessing the cardiovascular risk of antidiabetic drugs have been recently completed or are ongoing. The first novel drug class designated after 2008 is the dipeptidyl peptidase-4 (DPP-4) inhibitors. Trials of DPP-4 inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have shown a neutral effect on cardiovascular disease. Empagliflozin, a sodium-glucose co-transporter 2 inhibitor, significantly decreased the incidence of the primary cardiovascular end point, especially decreasing cardiovascular death and hospital admission for heart failure. Ongoing and future studies will provide better insight about the effects of each class and individual drug on cardiovascular disease.

Key Words: Antidiabetic drugs, Cardiovascular disease, Type 2 diabetes