Thursday , June 8 2023

Data for Diabetes Heart Data aimed at New Orientation


Recent studies show that glucose-lowering agents, such as GLP-1 receptor agonists, reduce liraglutide and semaglutide and SGLT-2 inhibitors to reduce cardiovascular events that are invasive and canaglifloxen. It is an important development, but it opens the door to increase research and education.

In this video, James Januzzi, MD, Roman W. DeSanctis, Academic Clinical Advisor, andDennis and Marilyn Barry Clinic Research Fellow Director In Boston's Boston General Hospital, The new cardologist and the American Cardiologist and the American Diabetes Association show how to give a practical guidance to the cardiologist.

Then, it is a transcript of his note:

I am here at the American Heart Association in Chicago, where we are listening to new data about the importance of interaction between the endocrine system and the cardiovascular system. In particular, patients with diabetes have a high risk of cardiovascular disease and cardiovascular disease has a much worse prognosis than patients with diabetes. And this is not a complication for macro-blemishes, for example, coronary heart disease, but also heart failure. This disease is a particularly mild problem for patients with diabetes.

Why is this topic also a conversation point? Well, in 2008, thanks to the treatment of Drugs and Food Safety, we have demonstrated that a number of new diabetes-based diabetes mellitus have been achieved by the development of diabetes-resistant diabetes diabetes patients. Security, but actually benefits from reducing cardiovascular events.

The situation we have traditionally talked about, diabetes has seen drugs like glucose lowering therapy: the so-called glucocentric vision, we use them, lowering glucose and decreases microvascular complications such as kidney dysfunction, neuropathy, and retinopathy. But, in general, anti-diabetes studies do not show benefits such as coronary heart disease or heart failure. In this space there are two new drug classes, glucagon-like agonist receptor peptides, GLP-1 agonist receptors, and sodium glucose cotransporter-2 or SGLT2 inhibitor drugs.

Therefore, these two drug classes have lower glucose, but they are drugs with diabetes. And they affect different ways. Apart from the activity mechanism, if cardiovascular trials examine their safety, we prove that each one independently reduces the risk of cardiovascular risk.

First of all, we will start with the GLP-1 receptor agonist. These are a class of injecting drugs that reduce blood glucose by means of mechanisms, because one of them reduces gastric inflammation, reduces glucagon secretion. As a result, they reduce blood glucose as a low effect. They cause weight loss, partly reducing appetite. Additionally, the results of cardiovascular trials seem to be interesting for drugs, especially atherothrombotic complications, myocardial infarction, stroke and cardiovascular death. So that's interesting.

And it has a drug, liraglutide, cardiovascular risk reduction. Sodium glucose-2-cotton drugs, SGLT2 drugs, are oral – a pill that reduces blood glucose by inducing glycosurysis, weighs glucose. Blood glucose is also modest to lower glucose levels. However, it has been quite enough, in clinical trials nowadays, we see a deep reduction in the cardiovascular risk in patients with drugs. An analysis of Emagliflozin and EMPA-REG results in the reduction of new cardiovascular and cardiac insufficiency events.

In the CANVAS study, cardiovascular diseases and cardiac insufficiency are reduced. And here at the American Heart Association's meeting, DECLARE TIMI-58 trial demonstrated that dapagliflozin, in particular, reduced the risk of cardiac insufficiency events. There is a heterogeneity of the SGLT2 inhibitor results, and if agrofifloxacin reduces cardiovascular and cardiac insufficiency, there is something like canagliflozin.

In the DECLARE study, dapagliflozin reduced cardiac insufficiency, but it does not appear to emerge from cardiovascular death.

Regardless, the bottom line of all the studies, together with GLP-1 receptor agonists or SGLT2 inhibitors, actually shows that cardiologists of our day should think of patients with diabetes, not only the risk of microdial complications, but also by the fact that diabetologists and primary care doctors, But now, like cardiologists, we must think of its macrobascular risk according to coronary heart disease and heart failure.

For this reason, the American College of Cardiology and the American Diabetes Association have worked together on how to prepare an educational orientation for the clinical relationship. The ACC has a document with the advice of experts in agreement with the patient, how and why the cardiovascular risk reduction in patients with diabetes is affected.

We will give you the knowledge that cardiologists should think about SGLT2 inhibitor or GLP-1 receptor agonist, stressing repeatedly that there is no reduction in blood glucose. We are moving away from the glycogenic vision and we really want to focus more attention on reducing cardiovascular risks. It's really remarkable, though cardiovascular medications have never thought of using drugs in this way, but these patients have a significant risk. It is imperative that the cardiologists fill in here and try to better manage these patients.

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