Review of Cardiovascular Effects of Antidiabetic Drugs and Recent Cardiovascular Outcome Trials

So Hun Kim

doi:10.4093/jkd.2015.17.1.1

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Kim: Review of Cardiovascular Effects of Antidiabetic Drugs and Recent Cardiovascular Outcome Trials

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J Korean Diabetes 2016;17(1):1-5.

Published online: 10 January 2016

DOI: https://doi.org/10.4093/jkd.2015.17.1.1

Review of Cardiovascular Effects of Antidiabetic Drugs and Recent Cardiovascular Outcome Trials

So Hun Kim

Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea

Corresponding author: So Hun Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University School of Medicine, 366 Seohae-daero, Jung-gu, Incheon 22332, Korea, E-mail: shoney@inha.ac.kr

Revised 29 January 2016 Accepted 5 February 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cardiovascular disease is a major cause of morbidity and mortality in people with type 2 diabetes. Therefore, the prevention of cardiovascular diseases is of great importance in these patients. Antidiabetic drugs may have cardiovascular effects independent of their glycemic effects. The highly publicized meta-analysis of rosiglitazone has triggered much concern about the cardiovascular effects of antidiabetic drugs. Since 2008, the US Food and Drug Administration (FDA) has required that all new antidiabetic drugs show proof of an acceptable cardiovascular risk profile. Because there is a lack of well-designed definitive studies, the cardiovascular risk/benefit is not definite in many drugs. Large randomized trials assessing the cardiovascular risk of antidiabetic drugs have been recently completed or are ongoing. The first novel drug class designated after 2008 is the dipeptidyl peptidase-4 (DPP-4) inhibitors. Trials of DPP-4 inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have shown a neutral effect on cardiovascular disease. Empagliflozin, a sodium-glucose co-transporter 2 inhibitor, significantly decreased the incidence of the primary cardiovascular end point, especially decreasing cardiovascular death and hospital admission for heart failure. Ongoing and future studies will provide better insight about the effects of each class and individual drug on cardiovascular disease.

Keywords: Antidiabetic drugs, Cardiovascular disease, Type 2 diabetes

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