Empagliflozin for Patients with Heart Failure and Type 2 Diabetes Mellitus: Clinical Evidence in Comparison with Other Sodium-Glucose Co-transporter-2 Inhibitors and Potential Mechanism

Liang, Bo; Li, Rui; Zhang, Peng; Gu, Ning

doi:10.1007/s12265-022-10302-4

Cited by 4 publications

(3 citation statements)

References 100 publications

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“…Patients with type 1 DM have a 5.1-fold and 3.4-fold higher associated risk for women and men of developing heart failure. This is compared to type 2, where the reported differences are minor and the associated risk is almost twice as high in both sexes, albeit higher for the female gender [43][44][45][46].…”

Section: Diabetes Mellitus and The Cardiovascular Continuummentioning

confidence: 77%

Old and Novel Predictors for Cardiovascular Risk in Diabetic Foot Syndrome—A Narrative Review

et al. 2023

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Diabetic foot syndrome (DFS) is a complication associated with diabetes that has a strong negative impact, both medically and socio-economically. Recent epidemiological data show that one in six patients with diabetes will develop an ulcer in their lifetime. Vascular complications associated with diabetic foot have multiple prognostic implications in addition to limiting functional status and leading to decreased quality of life for these patients. We searched the electronic databases of PubMed, MEDLINE and EMBASE for studies that evaluated the role of DFS as a cardiovascular risk factor through the pathophysiological mechanisms involved, in particular the inflammatory ones and the associated metabolic changes. In the era of evidence-based medicine, the management of these cases in multidisciplinary teams of “cardio-diabetologists” prevents the occurrence of long-term disabling complications and has prognostic value for cardiovascular morbidity and mortality among diabetic patients. Identifying artificial-intelligence-based cardiovascular risk prediction models or conducting extensive clinical trials on gene therapy or potential therapeutic targets promoted by in vitro studies represent future research directions with a modulating role on the risk of morbidity and mortality in patients with DFS.

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Section: Diabetes Mellitus and The Cardiovascular Continuummentioning

confidence: 77%

Old and Novel Predictors for Cardiovascular Risk in Diabetic Foot Syndrome—A Narrative Review

et al. 2023

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“…3 4 The cardiac benefits of SGLT2 inhibition with empagliflozin are not limited to patients with T2DM. 5 Similar benefits of reduced risk of worsening heart failure or cardiac death in patients with heart failure with reduced ejection fraction, as well as preserved ejection fraction, have been shown irrespective of diabetes status. [6][7][8] As in patients with T2DM, SGLT2 inhibitor use in patients with heart failure and normal glucose tolerance improves left ventricular volume, mass and systolic function.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 84%

“…The use of SGLT2 inhibitors in patients with type 2 diabetes mellitus (T2DM) improves composite cardiovascular and renal outcomes and is associated with reduced left ventricular end-diastolic volume measured by cardiac magnetic resonance (CMR), suggesting favourable effects on left ventricular remodelling 3 4. The cardiac benefits of SGLT2 inhibition with empagliflozin are not limited to patients with T2DM 5. Similar benefits of reduced risk of worsening heart failure or cardiac death in patients with heart failure with reduced ejection fraction, as well as preserved ejection fraction, have been shown irrespective of diabetes status 6–8.…”

Section: Introductionmentioning

confidence: 99%

Sodium glucose co-transporter 2 inhibition with empagliflozin on metabolic, cardiac and renal outcomes in recent cardiac transplant recipients (EMPA-HTx): protocol for a randomised controlled trial

et al. 2023

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IntroductionCardiac transplantation (CTx) is a life-saving operation that can improve the quality and length of a recipient’s life. Immunosuppression medication, required to prevent rejection, can result in adverse metabolic and renal effects. Clinically significant complications include metabolic effects such as diabetes and weight gain, renal impairment, and cardiac disease such as allograft vasculopathy and myocardial fibrosis. Sodium glucose co-transporter 2 (SGLT2) inhibitors are a class of oral medication that increase urinary excretion of glucose. In patients with type 2 diabetes, SGLT2 inhibitors improve cardiovascular, metabolic and renal outcomes. Similar benefits have been shown in patients with heart failure and reduced ejection fraction irrespective of diabetes status. In patients with post-transplant diabetes mellitus, SGLT2 inhibitors improve metabolic parameters; however, their benefit and safety have not been evaluated in randomised prospective studies. This study will potentially provide a novel therapy to improve or prevent complications (diabetes, kidney failure and heart fibrosis) that occur with immunosuppressive medications.MethodsThe EMPA-HTx study is a randomised, placebo-controlled trial of the SGLT2 inhibitor empagliflozin 10 mg daily versus placebo in recent CTx recipients. One hundred participants will be randomised 1:1 and commence the study medication within 6–8 weeks of transplantation with treatment and follow-up until 12 months after transplantation. Demographic information, anthropomorphic measurements, pathology tests and cardiac magnetic resonance (CMR) scan will be recorded at baseline and follow-up. Patients will be reviewed monthly during the study until 12 months post-CTx and data will be collected for each patient at each study visit. The overall aim of the study is to assess the safety and efficacy of empagliflozin in CTx recipients. The primary outcome is glycaemic improvement measured as change in glycated haemoglobin and/or fructosamine. Key secondary outcomes are cardiac interstitial fibrosis measured by CMR and renal function measured by estimated glomerular filtration rate.Ethics and disseminationThis study has been approved by St Vincent’s Hospital Human Research Ethics Committee (2021/ETH12184). The findings will be presented at national and international scientific meetings and published in peer-reviewed journals.Trial registration numberACTRN12622000978763.

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Predictors of Kidney Function Outcomes and Their Relation to SGLT2 Inhibitor Dapagliflozin in Patients with Type 2 Diabetes Mellitus Who Had Chronic Heart Failure

Berezina,

Fushtey,

Berezin

et al. 2023

Adv Ther

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Empagliflozin for Patients with Heart Failure and Type 2 Diabetes Mellitus: Clinical Evidence in Comparison with Other Sodium-Glucose Co-transporter-2 Inhibitors and Potential Mechanism

Cited by 4 publications

References 100 publications

Old and Novel Predictors for Cardiovascular Risk in Diabetic Foot Syndrome—A Narrative Review

Old and Novel Predictors for Cardiovascular Risk in Diabetic Foot Syndrome—A Narrative Review

Sodium glucose co-transporter 2 inhibition with empagliflozin on metabolic, cardiac and renal outcomes in recent cardiac transplant recipients (EMPA-HTx): protocol for a randomised controlled trial

Predictors of Kidney Function Outcomes and Their Relation to SGLT2 Inhibitor Dapagliflozin in Patients with Type 2 Diabetes Mellitus Who Had Chronic Heart Failure

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