Most Read Articles
13 Oct 2017
Higher circulating levels of docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA) appear to be protective against incident atherothrombotic and cardioembolic strokes, respectively, according to a recent study.
Roshini Claire Anthony, 11 Oct 2017

The prevalence of resistant hypertension may be lower than expected, particularly once pseudo-resistant hypertension due to treatment nonadherence is taken into account, according to a presentation at the recent APCH 2017.

Pank Jit Sin, 07 Jan 2015

Cardiovascular diseases (CVD) have been the main cause of death in the Malaysian population since 2007. This trend has continued, with the number of people dying from CVD-related causes increasing year on year. 

Tristan Manalac, 12 Oct 2017
Administration of a long-acting medication at the time that is most suitable for maximum patient compliance is the best approach in controlling blood pressure, said Dr. Trefor Morgan at the recently concluded 13th Asian-Pacific Congress of Hypertension (APCH 2017), held at the Suntec Singapore Convention and Exhibition Centre.

SGLT2 inhibitors may decrease heart failure risk

Audrey Abella
25 Jul 2017

The use of sodium-glucose co-transporter 2 (SGLT2) inhibitors such as empagliflozin and canagliflozin may lead to a decreased risk of heart failure (HF), according to data presented at the Asian Pacific Society of Cardiology Congress (APSC) 2017 held in Singapore.

“Empagliflozin, canagliflozin, and maybe metformin, are … beneficial [in reducing HF risk],” said Dr Darren McGuire from the University of Texas Southwestern Medical Center in Dallas, Texas, US, who highlighted the decreased HF risk with antihyperglycaemic agents as shown in the EMPA-REG OUTCOME* and CVD-REAL** trials.

In the EMPA-REG OUTCOME trial, 7,020 patients with prevalent atherosclerotic vascular disease and type 2 diabetes were randomized to receive placebo (n=2,333), empagliflozin 10 mg once daily (n=2,345), or empagliflozin 25 mg once daily (n=2,342). [N Engl J Med 2015;373:2117-2128; Cardiovasc Diabetol 2014;13:102]

The lower risk of HF among patients on empagliflozin was observed within the first 6–9 months of the trial (hazard ratio [HR], 0.65, 95 percent confidence interval [CI], 0.50–0.85; p=0.0017).

“[This] continued to divert slightly throughout the follow-up period … leading to the 35 percent relative risk reduction in incident [HF],” said McGuire, who suggested an increase in haematocrit (4 percent) as a potential reason for the reduction in HF. “This was a stunning finding … [W]e were very interested [to determine if] this was unique to empagliflozin or [if it was] a class effect.”

In the CVD-REAL trial, 154,528 participants receiving an SGLT2 inhibitor were matched with 154,528 individuals receiving other glucose-lowering drugs. [Circulation 2017;136:249-259]

Overall results revealed a decreased risk of hospitalization for HF with SGLT2 inhibitors (HR, 0.61, 95 percent CI, 0.51–0.73; p<0.001), which is also suggestive of a class effect, noted McGuire.

Given the favourable cardiovascular outcomes resulting from SGLT2 antagonist use, the European Society of Cardiology (ESC) HF prevention guidelines encourage the use of this class of glucose-control drugs, specifically empagliflozin, for cardiovascular death and HF risk reduction, noted McGuire.

McGuire pointed out that the benefits of metformin in this aspect warrants further investigation. “[There is] emerging data suggesting metformin may be in fact beneficial … [however], to this day, we have no idea what the cardiovascular safety or efficacy of metformin is, specifically [in relation] to HF.”

 

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Most Read Articles
13 Oct 2017
Higher circulating levels of docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA) appear to be protective against incident atherothrombotic and cardioembolic strokes, respectively, according to a recent study.
Roshini Claire Anthony, 11 Oct 2017

The prevalence of resistant hypertension may be lower than expected, particularly once pseudo-resistant hypertension due to treatment nonadherence is taken into account, according to a presentation at the recent APCH 2017.

Pank Jit Sin, 07 Jan 2015

Cardiovascular diseases (CVD) have been the main cause of death in the Malaysian population since 2007. This trend has continued, with the number of people dying from CVD-related causes increasing year on year. 

Tristan Manalac, 12 Oct 2017
Administration of a long-acting medication at the time that is most suitable for maximum patient compliance is the best approach in controlling blood pressure, said Dr. Trefor Morgan at the recently concluded 13th Asian-Pacific Congress of Hypertension (APCH 2017), held at the Suntec Singapore Convention and Exhibition Centre.