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.

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