Therapies for the Treatment of Cardiovascular Disease Associated with Type 2 Diabetes and Dyslipidemia

Abstract

Cardiovascular disease (CVD) is the leading cause of death worldwide and is the clinical manifestation of the atherosclerosis. Elevated LDL-cholesterol levels are the first line of therapy but the increasing prevalence in type 2 diabetes mellitus (T2DM) has positioned the cardiometabolic risk as the most relevant parameter for treatment. Therefore, the control of this risk, characterized by dyslipidemia, hypertension, obesity, and insulin resistance, has become a major goal in many experimental and clinical studies in the context of CVD. In the present review, we summarized experimental studies and clinical trials of recent anti-diabetic and lipid-lowering therapies targeted to reduce CVD. Specifically, incretin-based therapies, sodium-glucose co-transporter 2 inhibitors, and proprotein convertase subtilisin kexin 9 inactivating therapies are described. Moreover, the novel molecular mechanisms explaining the CVD protection of the drugs reviewed here indicate major effects on vascular cells, inflammatory cells, and cardiomyocytes, beyond their expected anti-diabetic and lipid-lowering control. The revealed key mechanism is a prevention of acute cardiovascular events by restraining atherosclerosis at early stages, with decreased leukocyte adhesion, recruitment, and foam cell formation, and increased plaque stability and diminished necrotic core in advanced plaques. These emergent cardiometabolic therapies have a promising future to reduce CVD burden.

Plin5, a New Target in Diabetic Cardiomyopathy

“…Obesity [ 78 ], IR [ 79 , 80 ], dyslipidemia [ 81 ], and type 2 diabetes (T2DM) [ 82 , 83 ] are basic risk factors for cardiovascular disease. These risk factors include imbalance of glucose, lipid metabolism, and changes in blood flow leading to heart remodeling [ 84 , 85 ].…”

Machine learning techniques comparison for risk assessment of cardiovascular disease development by health indicators / Comparação de técnicas de aprendizagem de máquinas para avaliação de risco de desenvolvimento de doença cardiovascular por indicadores de saúde

“…High levels of LDL-c cholesterol in the blood are directly related to the atherosclerotic process. On the other hand, the increase in blood sugar is marked by insulin resistance in these patients, which increases the dysfunction of endothelial cells, decreasing the bioavailability of vasodilators such as nitric oxide [6].…”

Adiponectin and Leptin Exert Antagonizing Effects on HUVEC Tube Formation and Migration Modulating the Expression of CXCL1, VEGF, MMP-2 and MMP-9

“…The vascular system is a complex biological system that plays a crucial role in various physio-pathological conditions such as tumor development, cardiovascular diseases (CVD) and atherosclerosis [ 1 ]. This latter is at the basis of majority of the vascular events, some of these that might lead to mortality.…”