2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes

Marx, Nikolaus; Federici, Massimo; Schuett, Katharina; Müller‐Wieland, Dirk; Ajjan, Ramzi; Antunes, Manuel J.; Christodorescu, Ruxandra; Crawford, Carolyn; Angelantonio, Emanuele Di; Eliasson, Björn; Espinola‐Klein, Christine; Fauchier, Laurent; Halle, Martin; Herrington, William G; Kautzky‐Willer, Alexandra; Lambrinou, Ekaterini; Lesiak, Maciej; Lettino, Maddalena; McGuire, Darren K.; Mullens, Wilfried; Sattar, Naveed; Cosentino, Francesco; Abdelhamid, Magdy; Antoniou, Sotiris; Asteggiano, Riccardo; Baumgartner, Iris; Bueno, Héctor; Čelutkienė, Jelena; Chieffo, Alaide; Christersson, Christina; Coats, Andrew J.S.; Cosyns, Bernard; Czerny, Martin; Deaton, Christi; Falk, Volkmar; Ference, Brian А.; Filippatos, Gerasimos; Fisher, Miles; Huikuri, Heikki V.; Jaarsma, Tiny; Khunti, Kamlesh; Lewis, Basil S.; Løchen, Maja-Lisa; Parati, Gianfranco; Patrono, Carlo; Petersen, Steffen E.; Piepoli, Massimo F; Rossing, Peter; Rydén, Lars; Standl, Eberhard; Tokgözoğlu, Lâle; Touyz, Rhian M.; Visseren, Frank L.J.; Volpe, Massimo; Hazarapetyan, Lusine; Zirlik, Andreas; Rustamova, Yasmin; Borne, Philippe van de; Sokolović, Šekib; Gotcheva, Nina; Miličić, Davor; Agathangelou, Petros; Vrablík, M.; Schou, Morten; Hasan‐Ali, Hosam; Viigimaa, Margus; Lautamäki, Riikka; Aboyans, Victor; Klimiashvili, Zurab; Kelm, Malte; Siasos, Gerasimos; Kiss, Róbert Gábor; Libungan, Berglind; Durkan, Maeve; Zafrir, Barak; Colivicchi, Furio; Tundybayeva, Meiramgul; Bytyçi, Ibadete; Mirrakhimov, Erkin M.; Trušinskis, Kārlis; Saadé, Georges; Badarienė, Jolita; Banu, Cristiana-Astra; Magri, Caroline Jane; Bošković, Aneta; Hattaoui, Mustapha El; Martens, Fabrice; Bosevski, Marijan; Knudsen, Eva Cecilie; Burchardt, Paweł; Fontes‐Carvalho, Ricardo; Vinereanu, Dragoş; Mancini, Tatiana; Beleslin, Branko; Martinka, Emil; Fras, Zlatko; Conde, Almudena Castro; Mellbin, Linda; Carballo, David; Bsata, Walid; Mghaieth, Fathia; Güngör, Barış; Mitchenko, O.; Wheatcroft, Stephen; Trigulova, Raisa; Prescott, Eva; James, Stefan; Arbelo, Elena; Baigent, Colin; Borger, Michael A.; Buccheri, Sergio; Ibáñez, Borja; Køber, Lars; Koskinas, Konstantinos C.; McEvoy, John W.; Mihaylova, Borislava; Mindham, Richard; Neubeck, Lis; Nielsen, Jens Cosedis; Pasquet, Agnès; Rakisheva, Amina; Rocca, Bianca; Rosselló, Xavier; Vaartjes, Ilonca; Vrints, Christiaan J.; Witkowski, Adam; Zeppenfeld, Katja

doi:10.1093/eurheartj/ehad192

Cited by 325 publications

(263 citation statements)

References 820 publications

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“…The Diabetes Lifetime-perspective prediction (DIAL) model was developed and validated using data on people with T2DM from the Swedish National Diabetes Registry (n = 389,366). 175 92 Most people with diabetes are obese, so weight control is crucial. Intensive lifestyle changes with low-calorie diets and mean weight losses in the region of 10 kg leads to remission of type 2 DM in around 46% of cases at 1 year and 36% by 2 years.…”

Section: Risk Predictionmentioning

confidence: 99%

“…90 Along with the confirmed increase in the risk of HF with Rosiglitazone in the RECORD trial (Rosiglitazone evaluated for cardiovascular outcomes in oral agent combination therapy for type 2 diabetes), 91 these observations formed the basis to recommend avoiding the use of thiazolidinediones for the treatment of T2DM in HF patients in the European Society of Cardiology Guidelines for the management of cardiovascular disease in patients with diabetes. 92 With respect to the "novel" glucose-lowering medications, recent CVOTs suggested a significantly higher risk of HF hospitalisation with Saxagliptin (a dipeptidyl peptidase-4 inhibitor), 93 and a numerically higher risk with Alogliptin (in the general population of patients with T2DM) and Vildagliptin (in patients with HFrEF). 94,95 GLP1-RAs appear to have a neutral effect on HF in the general population of patients with T2DM but in two small, randomized trials of patients with HFrEF, a safety concern was raised about the use of Liraglutide which led to numerically more adverse CV events compared with placebo.…”

Section: Glycaemic Control In Patients With T2dm and Hfmentioning

confidence: 99%

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Cardio‐renal‐metabolic disease in primary care setting

Ibrahim,

Ba‐Essa,

Baker

et al. 2023

Diabetes Metabolism Res

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In the primary care setting providers have more tools available than ever before to impact positively obesity, diabetes, and their complications, such as renal and cardiac diseases. It is important to recognise what is available for treatment taking into account diabetes heterogeneity. For those who develop type 2 diabetes (T2DM), effective treatments are available that for the first time have shown a benefit in reducing mortality and macrovascular complications, in addition to the well‐established benefits of glucose control in reducing microvascular complications. Some of the newer medications for treating hyperglycaemia have also a positive impact in reducing heart failure (HF). Technological advances have also contributed to improving the quality of care in patients with diabetes. The use of technology, such as continuous glucose monitoring systems (CGM), has improved significantly glucose and glycated haemoglobin A1c (HbA1c) values, while limiting the frequency of hypoglycaemia. Other technological support derives from the use of predictive algorithms that need to be refined to help predict those subjects who are at great risk of developing the disease and/or its complications, or who may require care by other specialists. In this review we also provide recommendations for the optimal use of the new medications; sodium‐glucose co‐transporter‐2 inhibitors (SGLT2i) and Glucagon‐like peptide‐receptor agonists 1 (GLP1RA) in the primary care setting considering the relevance of these drugs for the management of T2DM also in its early stage.

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Section: Risk Predictionmentioning

confidence: 99%

Section: Glycaemic Control In Patients With T2dm and Hfmentioning

confidence: 99%

Cardio‐renal‐metabolic disease in primary care setting

Ibrahim,

Ba‐Essa,

Baker

et al. 2023

Diabetes Metabolism Res

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“…LDL-C < 1,4 mmol/l (< 55 mg/dl) + Reduzierung um > 50 % gegenüber dem Ausgangswert LDL-C < 1,8 mmol/l (< 70 mg/dl) + Reduzierung um > 50 % gegenüber dem Ausgangswert LDL-C < 2,6 mmol/l (< 100 mg/dl)sehr hohes CV-Risiko hohes CV-Risiko moderates CV-RisikoNon-HDL-C < 2,6 mmol/l (< 100 mg/dl) Non-HDL-C < 2,2 mmol/l (< 85 mg/dl) ▶ Abb. 2 Zielwerte und -senkungen für LDL-Cholesterin in Abhängigkeit von der jeweiligen kardiovaskulären Risikokategorie[11].Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.menden Leitlinien Berücksichtigung finden.…”

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“…Personen mit Diabetes mellitus Typ 2 sollten daher nach Empfehlung der ESC-Guidelines anhand bestimmter Kriterien in verschiedene Risikogruppen eingeteilt werden (▶ Abb. 1)[11]. Einteilung in kardiovaskuläre Risikogruppen für Patienten mit Diabetes mellitus Typ 2[11].…”

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Diabetes mellitus: kardiovaskuläre Risikoreduktion im Fokus

Meyer-Steenbuck,

Seufert

2024

Kardiologie up2date

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First study with positive cardiovascular outcome in obesity: Reflections on SELECT

Pan,

Fei,

Xie

et al. 2024

Aging Medicine

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| BACKG ROU N D 1.1 | Clinical dilemmas: there is a heavy burden of cardiovascular diseases (CVD) in obesity, and medications for weight management while reducing cardiovascular risks are not yet clinically available Obesity, a recurring and progressive chronic disease, has emerged as a significant global public health concern, imposing substantial burdens on both human health and socioeconomic development. Recent data predict a sharp rise in the global overweight or obesity rate, from 38% in 2020 to an anticipated 51% by 2035, positioning half of the global population in these categories. 1 At present, about 50% of adults in China are overweight or obese, marking it as the country with the highest number of such cases worldwide. The prevalence peaks in the age groups of 55-59 and 70-74. The risk of cardiometabolic complications (non-alcoholic fatty liver disease, prediabetes, dyslipidemia, and hypertension, etc.) is significantly higher in overweight and obese individuals compared to those with normal body mass index (BMI). 2 In addition, overweight and obesity are independent risk factors for cardiovascular risks. 3 According to This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes

Cited by 325 publications

References 820 publications

Cardio‐renal‐metabolic disease in primary care setting

Cardio‐renal‐metabolic disease in primary care setting

Diabetes mellitus: kardiovaskuläre Risikoreduktion im Fokus

First study with positive cardiovascular outcome in obesity: Reflections on SELECT

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