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Heart failure and diabetes: management and open issues

Herzinsuffizienz und Diabetes mellitus: Behandlung und offene Fragen

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Abstract

Diabetes mellitus is an important comorbidity in patients with heart failure. The presence of heart failure in diabetes worsens the prognosis of patients. Recent studies suggest that appropriate diagnostic approaches followed by differential medical treatment are of crucial importance to improve patient outcomes. This article summarizes important aspects of the association between diabetes mellitus and heart failure.

Zusammenfassung

Diabetes mellitus stellt eine bedeutende Komorbidität bei Patienten mit Herzinsuffizienz dar. Durch das Vorliegen einer Herzinsuffizienz bei Diabetes mellitus verschlechtert sich die Prognose der Patienten. Um die Ergebnisse für die Patienten zu verbessern, sind aktuellen Studien zufolge entsprechend geeignete diagnostische Ansätze und daran anschließend eine differenzierte medizinische Behandlung von entscheidender Bedeutung. In dem vorliegenden Beitrag werden wichtige Aspekte des Zusammenhangs zwischen Diabetes mellitus und Herzinsuffizienz zusammengefasst.

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Abbreviations

ACE:

Angiotensin-converting enzyme

ARB:

Angiotensin II receptor blockers

ARNI:

Angiotensin receptor-neprilysin inhibitor

BNP:

Brain-type natriuretic peptide

CANVAS:

Canagliflozin Cardiovascular Assessment Study

CARMELINA:

The Cardiovascular and Renal Microvascular Outcome Study with Linagliptin in Patients with Type 2 Diabetes Mellitus

CAROLINA:

Cardiovascular Outcome Study of Linagliptin Versus Glimepiride in Patients with Type 2 Diabetes

CHARM:

Candesartan in Heart Failure—Assessment of Reduction in Mortality and Morbidity

COPD:

Chronic obstructive pulmonary disease

CRT:

Cardiac resynchronization therapy

CV:

Cardiovascular

DECLARE TIMI 58:

Multicenter Trial to Evaluate the Effect of Dapagliflozin on the Incidence of Cardiovascular Events

DIAMOND:

Danish Investigations of Arrhythmia and Mortality on Dofetilide

DPP-4:

Dipeptidyl peptidase-4

ECG:

Electrocardiography

EMPA-REG Outcome:

Empagliflozin, Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients

EXAMINE:

Cardiovascular Outcomes Study of Alogliptin in Patients with Type 2 Diabetes and Acute Coronary Syndrome

GIP:

Glucose-dependent insulinotropic peptide

GLP-1:

Glucagon-like peptide 1

HARMONY:

Effect of Albiglutide, When Added to Standard Blood Glucose-Lowering Therapies, on Major Cardiovascular Events in Subjects with Type 2 Diabetes Mellitus

HFmrEF:

Heart failure mid-range ejection fraction

HFpEF:

Heart failure with preserved ejection fraction

HFrEF:

Heart failure with reduced ejection fraction

ICD:

Implantable cardioverter defibrillator

LAVI:

Left atrial volume index

LEADER:

Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcomes Results

LVEF:

Left ventricular ejection fraction

LVMI:

Left ventricular mass index

MRA:

Mineralocorticoid receptor antagonists

MRI:

Magnetic resonance imaging

NT-proBNP:

N-terminal pro-brain natriuretic peptide

NYHA:

New York Heart Association

ORIGIN:

Outcome Reduction with Initial Glargine Intervention

PARADIGM-HF:

A Multicenter, Randomized, Double-blind, Parallel Group, Active-controlled Study to Evaluate the Efficacy and Safety of LCZ696 Compared to Enalapril on Morbidity and Mortality in Patients With Chronic Heart Failure and Reduced Ejection Fraction

SAVOR-TIMI 53:

A Multicentre, Randomised, Double-Blind, Placebo-Controlled Phase IV Trial to Evaluate the Effect of Saxagliptin on the Incidence of Cardiovascular Death, Myocardial Infarction or Ischaemic Stroke in Patients With Type 2 Diabetes

SGLT2:

Sodium-dependent glucose transporter

SUSTAIN 6:

A Long-Term, Randomised, Double-Blind, Placebo-Controlled, Multinational, Multi-Centre Trial to Evaluate Cardiovascular and Other Long-Term Outcomes with Semaglutide in Subjects with Type 2 Diabetes (SUSTAIN™ 6: Long-Term Outcomes)

TECOS:

A Randomized, Placebo Controlled Clinical Trial to Evaluate Cardiovascular Outcomes After Treatment with Sitagliptin in Patients with Type 2 Diabetes Mellitus and Inadequate Glycemic Control

UKPDS:

The UK Prospective Diabetes Study

VALIANT:

Valsartan in Acute Myocardial Infarction trial

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  1. Medizinische Klinik I, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

    K. Schütt & N. Marx

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K. Schütt declares the following: speaker fees from Amgen, AstraZeneca, Boehringer Ingelheim, MSD, Novo Nordisk, OmniaMed; research grant from Boehringer Ingelheim; advisory board member of Amgen, Boehringer Ingelheim. N. Marx declares the following: speaker fees from Amgen, Bayer, Boehringer Ingelheim, Sanofi-Aventis, MSD, BMS, AstraZeneca, Lilly, NovoNordisk, Bayer; research grant from Boehringer Ingelheim; advisory board member of Amgen, Bayer, Boehringer Ingelheim, Sanofi-Aventis, MSD, BMS, AstraZeneca, NovoNordisk. N. Marx declines all personal compensation from pharmaceutical or medical device companies.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Schütt, K., Marx, N. Heart failure and diabetes: management and open issues. Herz 44, 203–209 (2019). https://doi.org/10.1007/s00059-019-4792-9

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