Possible mechanisms of direct cardiovascular impact of GLP-1 agonists and DPP4 inhibitors

Heart Fail Rev. 2018 May;23(3):377-388. doi: 10.1007/s10741-018-9674-3.

Abstract

Diabetes mellitus is a leading cause of cardiovascular morbidity and mortality worldwide. Traditional antidiabetic therapies targeting hyperglycemia reduce diabetic microvascular complications but have minor effects on macrovascular complications, including cardiovascular disease. Instead, cardiovascular complications are improved by antidiabetic medications (metformin) and other therapies (statins, antihypertensive medications) ameliorating insulin resistance and other associated metabolic abnormalities. Novel classes of antidiabetic drugs have proven efficacious in improving glycemia, while at the same time exert beneficial effects on pathophysiologic mechanisms of diabetes-related cardiovascular disease. In the present review, we will present current evidence of the cardiovascular effects of two new classes of antidiabetic medications, glucagon-like peptide 1 (GLP-1) agonists and dipeptidyl peptidase-4 (DPP4) inhibitors, focusing from mechanistic preclinical and clinical investigation to late-phase clinical testing.

Keywords: Cardiovascular outcomes; DPP4 inhibitors; GLP-1 agonists; New antidiabetic drugs; Type 2 diabetes mellitus.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology*
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy
  • Dipeptidyl-Peptidase IV Inhibitors / pharmacology*
  • Global Health
  • Glucagon-Like Peptide 1 / agonists*
  • Humans
  • Hypoglycemic Agents / pharmacology*
  • Morbidity / trends

Substances

  • Dipeptidyl-Peptidase IV Inhibitors
  • Hypoglycemic Agents
  • Glucagon-Like Peptide 1