Differential indication for SGLT-2 inhibitors versus GLP-1 receptor agonists in patients with established atherosclerotic heart disease or at risk for congestive heart failure

Francesco Giorgino; Irene Caruso; Julia Moellmann; Michael Lehrke

doi:10.1016/j.metabol.2019.154045

Differential indication for SGLT-2 inhibitors versus GLP-1 receptor agonists in patients with established atherosclerotic heart disease or at risk for congestive heart failure

Metabolism. 2020 Mar:104:154045. doi: 10.1016/j.metabol.2019.154045. Epub 2019 Dec 7.

Authors

Francesco Giorgino¹, Irene Caruso², Julia Moellmann³, Michael Lehrke⁴

Affiliations

¹ Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy. Electronic address: [email protected].
² Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.
³ Department of Internal Medicine I-Cardiology, University Hospital Aachen, Aachen, Germany.
⁴ Department of Internal Medicine I-Cardiology, University Hospital Aachen, Aachen, Germany. Electronic address: [email protected].

PMID: 31821814
DOI: 10.1016/j.metabol.2019.154045

Abstract

SGLT-2 inhibitors and most GLP-1 receptor agonists demonstrated cardiovascular superiority and reduction of cardiovascular and overall mortality. These results stand as a turning point in the management of diabetes, shifting the focus from controlling glucose levels to mastering the extra-glycemic effects of these new drugs. This narrative review will discuss recent CVOT with focus on SGLT-2 inhibitors and GLP-1 receptor agonists to distinguish relevant patients' characteristics as potential predictors for therapeutic efficacy. It will also examine their efficacy and safety, the differences in their cardiovascular and renal benefits, aiming to convey clinical suggestions for everyday practice.

Keywords: Cardiovascular; Chronic kidney disease; GLP-1 receptor agonists; Heart failure; SGLT-2 inhibitors.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Animals
Cardiomyopathy, Dilated / drug therapy*
Cardiomyopathy, Dilated / mortality
Coronary Artery Disease / drug therapy*
Coronary Artery Disease / mortality
Glucagon-Like Peptide-1 Receptor / agonists*
Humans
Sodium-Glucose Transporter 2 Inhibitors / therapeutic use*

Substances

Glucagon-Like Peptide-1 Receptor
Sodium-Glucose Transporter 2 Inhibitors