Cardiovascular risk and the implications for clinical practice of cardiovascular outcome trials in type 2 diabetes

Prim Care Diabetes. 2020 Jun;14(3):193-212. doi: 10.1016/j.pcd.2019.09.008. Epub 2019 Nov 6.

Abstract

Cardiovascular disease (CVD) is the primary cause of morbidity and mortality in patients with type 2 diabetes (T2D). This review examines the impact of cardiovascular outcome trials (CVOTs) on clinical practice. To date, all CVOTs have shown non-inferiority versus placebo (both added to standard of care) against a primary endpoint of 3- or 4-point major adverse cardiovascular event (MACE), confirming CV safety of these treatments. Additionally, some CVOTs have shown superiority to placebo against the same MACE endpoint, suggesting a cardioprotective action for these treatments. This is reflected in guideline updates, which primary care physicians should consider when personalizing treatments.

Keywords: Antihyperglycemic; Cardiovascular outcome trials; Cardiovascular risk; Type 2 diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Glucose / metabolism
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Clinical Trials as Topic*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Risk Factors

Substances

  • Blood Glucose
  • Hypoglycemic Agents