Prognostic value of arterial stiffness measurements in cardiovascular disease, diabetes, and its complications: The potential role of sodium‐glucose co‐transporter‐2 inhibitors

Abstract

Type 2 diabetes mellitus (T2DM) constitutes a global pandemic, representing the 7th cause of death worldwide. Morbidity and mortality of patients with T2DM are gradually increasing, while prevalence of cardiovascular disease (CVD) among these patients is almost 14% greater compared to the general population. Arterial stiffness is nowadays a valuable biomarker of CVD and a promising treatment target in specific patient groups, including those suffering from T2DM. Despite that fact, design of the available studies cannot prove causal relationship. Recently, a new antidiabetic drug class, namely sodium-glucose co-transporter-2 (SGLT-2) inhibitors, has attracted scientific interest, due to their multiple, beneficial, pleiotropic effects, especially those focused on CVD. There is limited relevant literature concerning the effects of SGLT-2 inhibitors on arterial stiffness, while retrieved results might be considered as conflicting. The aim of the present review article is to summarize acquired knowledge regarding the prognostic role of arterial stiffness in T2DM, along with the presentation of retrieved data on the potential role of SGLT-2 inhibitors. | 563 PATOULIAS eT AL.

Impact of diabetic retinopathy on pulse wave analysis-derived arterial stiffness and hemodynamic parameters: A cross-sectional study from Gujarat, India

“…We found no association between DR and PWA parameters: AS, BH, and CH. This is in contrast to others studies,[ 11 12 13 ] which reported a significant impact on AS, BH, and CH of DR as well as retinal microvascular changes. [ 14 15 16 ] There can be few reasons.…”

Arterial stiffness is an independent predictor for risk of mortality in patients with type 2 diabetes mellitus: the REBOUND study

“…Zhang et al reported a positive association between baPWV and the risk of new-onset diabetes in hypertensive patients [ 27 ]. It is possibly caused by advanced glycation end product formation with collagen cross-linking, oxidative stress, inflammatory process, and insulin resistance [ 28 – 31 ]. Multiple pharmacologic agents have been proposed to improve arterial stiffness.…”

Effect of tofogliflozin on arterial stiffness in patients with type 2 diabetes: prespecified sub-analysis of the prospective, randomized, open-label, parallel-group comparative UTOPIA trial

“…In addition, our previous study indicated that elevated levels of plasma indoxyl sulfate, a uremic toxin, was related to increased baPWV [ 46 ]. Although it has been demonstrated that SGLT2 inhibition ameliorates insulin resistance, decreases the expression of AGEs, and suppresses oxidative stress and inflammatory response [ 19 ], these aspects were not elucidated in the present study.…”

“…However, several studies did not find beneficial effects of this class of antidiabetics on arterial stiffness [ 18 ]. Patoulias et al recently reviewed and summarized clinical studies on this topic and concluded that evidence on the effect of SGLT2 inhibitors on arterial stiffness remains limited and controversial [ 19 ].…”

“…Previous studies have evaluated the effect of SGLT2 inhibitors on arterial stiffness using several indices [ 8 – 19 ], some of which indicated the beneficial effect of SGLT inhibitors. Pulse wave velocity (PWV) is commonly used to measure the severity of arterial stiffness, showing the structural and functional properties of the arterial wall [ 20 , 21 ].…”