The incidence of congestive heart failure associated with antidiabetic therapies

Nichols, Gregory A.; Koro, Carol E.; Gullion, Christina M.; Ephross, Sara A.; Brown, Jonathan B.

doi:10.1002/dmrr.480

Cited by 95 publications

(55 citation statements)

References 40 publications

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“…Some agents, such as thiazolidinediones and dual peroxisome proliferator-activated receptor α/γ agonists, increase plasma volume and exacerbate heart failure, [7][8][9][10][11] whereas sulfonylureas 12 and insulin potentially exacerbate the dysregulation of myocardial metabolism and worsen left ventricular function. 13,14 Metformin, once felt to be contraindicated in patients with heart failure, is now considered to be 1 of the safest options, despite the absence of large randomized comparisons. 15,16 Despite the observational relationship between glycemic control and the risk of heart failure, there is no evidence that improved glycemic control modifies this risk.…”

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confidence: 99%

Heart Failure, Saxagliptin, and Diabetes Mellitus: Observations from the SAVOR-TIMI 53 Randomized Trial

et al. 2014

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iabetes mellitus (DM) adds incremental risk of the development and subsequent exacerbation of heart failure even after adjusting for common risk factors, such as ischemic heart disease and hypertension.1 Although incompletely understood, cardiac metabolic dysregulation of glycolysis and fatty acid oxidation observed in the heart of patients with Background-Diabetes mellitus and heart failure frequently coexist. However, few diabetes mellitus trials have prospectively evaluated and adjudicated heart failure as an end point. Methods and Results-A total of 16 492 patients with type 2 diabetes mellitus and a history of, or at risk of, cardiovascular events were randomized to saxagliptin or placebo (mean follow-up, 2.1 years). The primary end point was the composite of cardiovascular death, myocardial infarction, or ischemic stroke. Hospitalization for heart failure was a predefined component of the secondary end point. Baseline N-terminal pro B-type natriuretic peptide was measured in 12 301 patients. More patients treated with saxagliptin (289, 3.5%) were hospitalized for heart failure compared with placebo (228, 2.8%; hazard ratio, 1.27; 95% confidence intercal, 1.07-1.51; P=0.007). Corresponding rates at 12 months were 1.9% versus 1.3% (hazard ratio, 1.46; 95% confidence interval, 1.15-1.88; P=0.002), with no significant difference thereafter (time-varying interaction, P=0.017). Subjects at greatest risk of hospitalization for heart failure had previous heart failure, an estimated glomerular filtration rate ≤60 mL/min, or elevated baseline levels of N-terminal pro B-type natriuretic peptide. There was no evidence of heterogeneity between N-terminal pro B-type natriuretic peptide and saxagliptin (P for interaction=0.46), although the absolute risk excess for heart failure with saxagliptin was greatest in the highest N-terminal pro B-type natriuretic peptide quartile (2.1%). Even in patients at high risk of hospitalization for heart failure, the risk of the primary and secondary end points were similar between treatment groups. Conclusions-In the context of balanced primary and secondary end points, saxagliptin treatment was associated with an increased risk or hospitalization for heart failure. This increase in risk was highest among patients with elevated levels of natriuretic peptides, previous heart failure, or chronic kidney disease. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01107886.

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confidence: 99%

Heart Failure, Saxagliptin, and Diabetes Mellitus: Observations from the SAVOR-TIMI 53 Randomized Trial

et al. 2014

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“…Cardiovascular disease, such as atherosclerosis or congestive heart failure, is often present in patients with T2DM [20,21]. clinicaltrials.gov identifier: NCT00904176).…”

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confidence: 99%

Lack of Pharmacokinetic Interactions Between Dapagliflozin and Simvastatin, Valsartan, Warfarin, or Digoxin

Kasichayanula

Chang²,

Liu

et al. 2012

Adv Therapy

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“…La síntesis de ácidos grasos es regulada por la ACC, la cual es una enzima que utilizando como cofactor la biotina, adiciona de manera irreversible un grupo bicarbonato al acetil-CoA para producir mayor que en población sin DM2 y se ve reducida con el uso de metformina 90,91 .…”

Section: Control Lipídicounclassified

“…En el estudio realizado por miembros del centro Kaiser Permanente Northwest, el uso de metformina asociado a dieta y ejercicio mostró una reducción en la tasa de incidencias de falla cardiaca comparada con sulfunilurea (razón de tasas = 0,48, p= 0,016) 91 . Además, se asocia a disminución en los niveles de N-terminal Pro-Péptido Natriurético Cerebral disminuyendo la prevalencia de valores superiores a 200 pg/mL.…”

Section: Control Lipídicounclassified

Metformina: más allá del control glucémico

Morantes-Caballero

Londoño-Zapata

Rubio-Rivera

et al. 2017

revmed

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RESUMENIntroducción: la metformina es una biguanida que disminuye gluconeogénesis e incrementa la recaptación de glucosa en los músculos, sin embargo, más allá del glucémico se han documentado beneficios adicionales como la disminución de complicaciones crónicas derivadas de la hiperglucemia, entre ellas las cardiovasculares y del síndrome metabólico per se. Objetivo: identificar los efectos de la metformina diferentes al control control glucémico en población con diabetes mellitus, con el fin de contribuir a difundir el conocimiento. Materiales y método: tres revisores independientes realizaron la búsqueda en distintas bases de datos entre ellas Pubmed y ScienceDirect, utilizando los términos Metfomin AND Cardiovascular disease AND inflamatory response AND Hyperlipidemia, Biguanides, Diabetes Mellitus, Diabetes complications, Obesity, Vascular diseases AND Cancer; y Metfomina y enfermedad cardiovascular, metformina y cáncer se seleccionaron los artículos desde el año 2010, encontrando 13 828 artículos, de los cuales se incluyeron 144. Conclusión: más allá del control glucémico, la metformina, modifica la "memoria metabólica", reduce mediadores inflamatorios y el grosor de pared arterial, disminuye factores trombóticos y reduce la prevalencia de falla cardiaca logrando impactar la morbimortalidad y mediante cambios moleculares o genéticos, tiene potencial uso como anticancerígeno. El clínico debe conocer estos efectos para favorecer su pronto inicio en los casos indicados. Metformin: beyond the glycemic targetABSTRACT Introduction: the metformin is a biguanide which main action is to decrease hepatic glucose output, primarily by decreasing gluconeogenesis, and increase glucose uptake by muscles. However, beyond the glycemic target, additional benefits have been documented like a decrease in chronic complications to hyperglycemia, including cardiovascular comorbility and metabolic syndrome. Objetive: to identify effects of metformin other than glycemic control in patients with diabetes mellitus in order to help disseminate knowledge. Materials and methods: three independent reviewers searched in different databases of PubMed and ScienceDirect using the DeCS and MeSH terms: Metfomin AND Cardiovascular disease AND inflamatory response AND Hyperlipidemia, Biguanides, Diabetes Mellitus, Diabetes complications,Obesity, Vascular diseases AND Cancer, selecting the items since 2010 year and prior to warrant mention. Search based publications that were considered most relevant and, additionally, a manual search of the referenced articles in publications retrieved in the initial search was conducted, 13 828 articles were found but 144 were included finally. Conclusion: beyond glycemic control, Metformin, modifies the "metabolic memory", reduces inflammatory mediators and thickness of arterial wall, decreases thrombotic factors and reduces the prevalence of heart failure making an impact morbidity and mortality and because of molecular or genetic changes, it has potential use as anticarcinogenic. The physicians should know...

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The incidence of congestive heart failure associated with antidiabetic therapies

Abstract: Our findings support the theory that elevated serum insulin levels promote the development of cardiac disease. Consistent with the UKPDS, metformin may offer some protection from incident CHF relative to sulphonylurea or insulin.

Cited by 95 publications

References 40 publications

Heart Failure, Saxagliptin, and Diabetes Mellitus: Observations from the SAVOR-TIMI 53 Randomized Trial

Heart Failure, Saxagliptin, and Diabetes Mellitus: Observations from the SAVOR-TIMI 53 Randomized Trial

Lack of Pharmacokinetic Interactions Between Dapagliflozin and Simvastatin, Valsartan, Warfarin, or Digoxin

Metformina: más allá del control glucémico

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