Expert discusses heart failure with reduced ejection fraction in patients with diabetes

PHILADELPHIA — There is evidence from multiple studies that suggests that the drug and the stage of heart failure and drug choice play a large role in evaluating treatments for type 2 diabetes, according to Kenneth B. Margulies, MD, professor of medicine at the Perelman School of Medicine at the University of Pennsylvania and a presenter at the Heart in Diabetes conference.

In heart failure with reduced ejection fraction, also known as systolic heart failure (HF), the heart muscle is not able to contract adequately and, therefore, expels less oxygen-rich blood into the body. Patients with this form of the disease will have lower-than-normal left ventricular ejection fraction on an echocardiogram.

“HF and type 2 diabetes mellitus are two contemporary and overlapping epidemics. [Approximately] 40% of patients with HF have type 2 diabetes with the highest rates of comorbidity in hospitalization registries,” Margulies said. “Patients with both diabetes and HF have a poor prognosis, with a median survival of 4 years.”

In his presentation, Margulies refers to various studies that show early- and late-stage outcomes of HF treatment with GLP-1 antagonists. Endocrine Today has compiled a list of five articles discussing those studies and their outcomes.

EMPA-REG Outcome: Empagliflozin reduces risk for HF endpoints

ORLANDO, Fla. — Empagliflozin, an SGLT2 inhibitor, is associated with decreased risk for HF hospitalization or CV death and other HF-related endpoints, according to new data from the EMPA-REG Outcome study.

Canagliflozin reduces risk for CVD, kidney disease in patients with type 2 diabetes

SAN DIEGO — Patients with type 2 diabetes at high risk for cardiovascular disease assigned the SGLT2 inhibitor canagliflozin saw a 33% reduction in risk for hospitalization for heart failure and were 40% less likely to experience renal decline vs. those assigned placebo, according to findings from the integrated CANVAS study presented here.

LEADER trial: Victoza lowers risk for CV death, MI, stroke in high-risk type 2 diabetes

Patients with type 2 diabetes and a history of cardiovascular disease assigned Victoza therapy saw reduced risk for cardiovascular death, nonfatal myocardial infarction and stroke vs. those assigned a placebo, according to an analysis of the LEADER trial results presented at the American Diabetes Association Scientific Sessions.

Lyxumia trial shows neutral CV risk in adults with type 2 diabetes, high risk for CVD

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BOSTON — The GLP-1 receptor agonist Lyxumia lowers HbA1c without any cardiovascular risk or benefit in adults with type 2 diabetes at high risk for acute cardiovascular events, according to study findings presented here.

SUSTAIN-6: Retinopathy complications may be increased with semaglutide

SAN DIEGO — An analysis of data from SUSTAIN-6, the cardiovascular outcome trial of the glucagon-like peptide 1 receptor agonist semaglutide, sheds light on the increased rate of diabetic retinopathy complications found in the treatment groups compared with the placebo groups, according to a speaker here.

Reference:

Margulies KB. Congestive Heart Failure in Diabetes. Presented at: Heart in Diabetes Medical Conference; July 14-16, 2017; Philadelphia.

Disclosure: Margulies reports receiving research grants from Celladon, Innolign Biomedical, Juventas Therapeutics and Thoratec, and serving as a consultant or on advisory boards for AstraZeneca, Janssen, Merck, Novo Nordisk (unpaid), Pfizer and Ridgetop Research.