Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 3 de 3
Filtrar
Mais filtros

Base de dados
Tipo de documento
Intervalo de ano de publicação
1.
Circulation ; 147(4): 284-295, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36335517

RESUMO

BACKGROUND: Sodium-glucose cotransporter 2 inhibitors have been demonstrated to promote reverse cardiac remodeling in people with diabetes or heart failure. Although it has been theorized that sodium-glucose cotransporter 2 inhibitors might afford similar benefits in people without diabetes or prevalent heart failure, this has not been evaluated. We sought to determine whether sodium-glucose cotransporter 2 inhibition with empagliflozin leads to a decrease in left ventricular (LV) mass in people without type 2 diabetes or significant heart failure. METHODS: Between April 2021 and January 2022, 169 individuals, 40 to 80 years of age, without diabetes but with risk factors for adverse cardiac remodeling were randomly assigned to empagliflozin (10 mg/d; n=85) or placebo (n=84) for 6 months. The primary outcome was the 6-month change in LV mass indexed (LVMi) to baseline body surface area as measured by cardiac magnetic resonance imaging. Other measures included 6-month changes in LV end-diastolic and LV end-systolic volumes indexed to baseline body surface area and LV ejection fraction. RESULTS: Among the 169 participants (141 men [83%]; mean age, 59.3±10.5 years), baseline LVMi was 63.2±17.9 g/m2 and 63.8±14.0 g/m2 for the empagliflozin- and placebo-assigned groups, respectively. The difference (95% CI) in LVMi at 6 months in the empagliflozin group versus placebo group adjusted for baseline LVMi was -0.30 g/m2 (-2.1 to 1.5 g/m2; P=0.74). Median baseline (interquartile range) NT-proBNP (N-terminal-pro B-type natriuretic peptide) was 51 pg/mL (20-105 pg/mL) and 55 pg/mL (21-132 pg/mL) for the empagliflozin- and placebo-assigned groups, respectively. The 6-month treatment effect of empagliflozin versus placebo (95% CI) on blood pressure and NT-proBNP (adjusted for baseline values) were -1.3 mm Hg (-5.2 to 2.6 mm Hg; P=0.52), 0.69 mm Hg (-1.9 to 3.3 mm Hg; P=0.60), and -6.1 pg/mL (-37.0 to 24.8 pg/mL; P=0.70) for systolic blood pressure, diastolic blood pressure, and NT-proBNP, respectively. No clinically meaningful between-group differences in LV volumes (diastolic and systolic indexed to baseline body surface area) or ejection fraction were observed. No difference in adverse events was noted between the groups. CONCLUSIONS: Among people with neither diabetes nor significant heart failure but with risk factors for adverse cardiac remodeling, sodium-glucose cotransporter 2 inhibition with empagliflozin did not result in a meaningful reduction in LVMi after 6 months. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT04461041.


Assuntos
Diabetes Mellitus Tipo 2 , Insuficiência Cardíaca , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Compostos Benzidrílicos/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Glucose , Sódio , Volume Sistólico , Remodelação Ventricular , Feminino
2.
Curr Opin Cardiol ; 33(6): 676-682, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30148719

RESUMO

PURPOSE OF REVIEW: To address common concerns regarding sodium-glucose cotransporter 2 (SGLT2) inhibitor use for patients with type 2 diabetes mellitus (T2DM) in cardiovascular practice. RECENT FINDINGS: SGLT2 inhibitors provide glycemic control and improve cardiovascular and renal endpoints in T2DM. Cardiovascular outcome trials have demonstrated sustained cardiovascular, heart failure and renal benefits independent of glycemic control, which persist down to an eGFR of 30 ml/min/1.73 m. SGLT2 inhibitors can be safely administered alongside common diuretics, and routine monitoring of renal function is advised at initiation of therapy, particularly for patients on loop diuretics. Mild initial reductions in eGFR are expected, usually stabilizing over time. The most common adverse effect noted with SGLT2 inhibitors is genital mycotic infections, primarily in women. Less common, but concerning effects associated with canagliflozin include increased risk of fractures and lower limb amputations, particularly in patients with previous amputation history. Overall, SGLT2 inhibitors are well tolerated and effective adjuncts to diabetic treatment, for which the benefits seem to outweigh the risks. SUMMARY: The care of patients with T2DM requires an interdisciplinary team approach, within which the role of cardiologists is expanding. SGLT2 inhibitors are an encouraging treatment option for achieving glycemic control, whilst also improving cardiovascular and renal outcomes.


Assuntos
Cardiologistas , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/tratamento farmacológico , Guias de Prática Clínica como Assunto , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Glicemia/efeitos dos fármacos , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Humanos , Hipoglicemiantes/uso terapêutico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA