The impact of oral anti-diabetic medications on heart failure: lessons learned from preclinical studies

Abstract

The prevalence of heart failure (HF) in the diabetic population has rapidly increased over the past 2 decades, triggering research about the impact of oral anti-diabetic medications on it. Unfortunately, not all success at the bench in preclinical experiments has translated to success at the bedside. On the other hand, recent promising clinical data from oral SGLT2 inhibitors mainly lack mechanistic explanation from experimental studies. Hence, it is critical to understand the lessons learned from prior translational studies to gain a better knowledge of the mechanisms of oral anti-diabetic drugs in HF. This review aims to summarize the results from preclinical studies regarding the interaction between oral anti-diabetic medications and heart failure development and/or exacerbation. Although there is a wide spectrum of controversial results, the underlying hope is that the clinical success rate will improve and the adverse events during ineffective targeted therapy will be limited.

The cardiovascular‐protective properties of saffron and its potential pharmaceutical applications: A critical appraisal of the literature

“…Diabetes is a multi‐metabolic disorder characterized by hyperglycemia and an atherogenesis predisposition by clustering several atherogenetic mechanisms such as: deposition of glycosylated end‐products, hyperlipidemia, oxidative stress (imbalance between ROS and antioxidant defenses), insulin resistance, low‐grade inflammation, and so forth (Kadoglou et al, 2013; Lambadiari, Dimitriadis, & Kadoglou, 2018). Moreover, hyperglycemia has been predominantly related to microvascular and to a lesser extent to macrovascular disease and cardiomyopathy (Valensi, Prévost, Schnell, Standl, & Ceriello, 2019).…”

“…Diabetes is a multi-metabolic disorder characterized by hyperglycemia and an atherogenesis predisposition by clustering several atherogenetic mechanisms such as: deposition of glycosylated end-products, hyperlipidemia, oxidative stress (imbalance between ROS and antioxidant defenses), insulin resistance, low-grade inflammation, and so forth (Kadoglou et al, 2013;Lambadiari, Dimitriadis, & Kadoglou, 2018).…”

Metabolic Effects of Metformin in the Failing Heart

“…Moreover, patients with diabetes account for one third of all cases of HF [ 1 ]. As the prevalence of diabetes rapidly rises worldwide, the incidence of HF consequently increases in parallel [ 2 ]. The concomitance of diabetes and heart failure significantly worsens a prognosis in this group of patients.…”