TY - JOUR
T1 - Targeting multiple domains of residual cardiovascular disease risk in patients with diabetes
AU - Patel, Kershaw V.
AU - Vaduganathan, Muthiah
N1 - Funding Information:
K.V.P. is supported by the National Heart, Lung, and Blood Institute T32 postdoctoral training grant (5T32HL125247-03). M.V. is supported by the KL2/Catalyst Medical Research Investigator Training award from Harvard Catalyst (NIH/NCATS Award UL 1TR002541).
Funding Information:
M.V. serves on advisory boards for Amgen, AstraZeneca, Baxter Healthcare, Bayer AG, Boehringer Ingelheim, Cytokinetics, and Relypsa, and participates on clinical endpoint committees for studies sponsored by Novartis and the NIH.
Publisher Copyright:
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/9
Y1 - 2020/9
N2 - Purpose of review There has been a recent resurgence of diabetes-related cardiovascular complications after years of steady improvement. This review highlights established and emerging contemporary secondary prevention approaches that lower the risk of atherosclerotic and nonatherosclerotic cardiovascular disease events among patients with diabetes. Recent findings Secondary prevention therapies modify residual risk targets, including cardiometabolic pathways, lipoproteins, thrombosis, and inflammation. Large-scale clinical trials of sodium-glucose cotransporter-2 inhibitors have demonstrated significant reductions in hospitalization for heart failure. Glucagon-like peptide-1 receptor agonists have reduced the risk of major adverse cardiovascular events. Recent clinical trials provide evidence supporting the use of nonstatin lipid-lowering therapies, novel antiplatelet and anticoagulant strategies, and antiinflammatory strategies in select cases. Summary Therapeutic approaches targeting multiple distinct pathways have been shown to improve cardiometabolic risk in diabetes. Individual patient characteristics and consideration of residual risk targets may help guide selection of comprehensive secondary prevention approaches.
AB - Purpose of review There has been a recent resurgence of diabetes-related cardiovascular complications after years of steady improvement. This review highlights established and emerging contemporary secondary prevention approaches that lower the risk of atherosclerotic and nonatherosclerotic cardiovascular disease events among patients with diabetes. Recent findings Secondary prevention therapies modify residual risk targets, including cardiometabolic pathways, lipoproteins, thrombosis, and inflammation. Large-scale clinical trials of sodium-glucose cotransporter-2 inhibitors have demonstrated significant reductions in hospitalization for heart failure. Glucagon-like peptide-1 receptor agonists have reduced the risk of major adverse cardiovascular events. Recent clinical trials provide evidence supporting the use of nonstatin lipid-lowering therapies, novel antiplatelet and anticoagulant strategies, and antiinflammatory strategies in select cases. Summary Therapeutic approaches targeting multiple distinct pathways have been shown to improve cardiometabolic risk in diabetes. Individual patient characteristics and consideration of residual risk targets may help guide selection of comprehensive secondary prevention approaches.
KW - Cardiovascular disease
KW - Diabetes
KW - Residual risk
KW - Secondary prevention
UR - http://www.scopus.com/inward/record.url?scp=85089300817&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089300817&partnerID=8YFLogxK
U2 - 10.1097/HCO.0000000000000762
DO - 10.1097/HCO.0000000000000762
M3 - Review article
C2 - 32649348
AN - SCOPUS:85089300817
SN - 0268-4705
VL - 35
SP - 517
EP - 523
JO - Current Opinion in Cardiology
JF - Current Opinion in Cardiology
IS - 5
ER -