Bourazana A, Giamouzis G, Skoularigis J, Triposkiadis F, Xanthopoulos A. Glucose lowering does not necessarily reduce cardiovascular risk in type 2 diabetes. World J Cardiol 2022; 14(4): 266-270 [PMID: 35582467 DOI: 10.4330/wjc.v14.i4.266]
Corresponding Author of This Article
Andrew Xanthopoulos, FACC, MD, PhD, Doctor, Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. andrewvxanth@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Apr 26, 2022; 14(4): 266-270 Published online Apr 26, 2022. doi: 10.4330/wjc.v14.i4.266
Glucose lowering does not necessarily reduce cardiovascular risk in type 2 diabetes
Angeliki Bourazana, Grigorios Giamouzis, John Skoularigis, Filippos Triposkiadis, Andrew Xanthopoulos
Angeliki Bourazana, Grigorios Giamouzis, John Skoularigis, Filippos Triposkiadis, Andrew Xanthopoulos, Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
Author contributions: Bourazana A and Xanthopoulos A wrote the letter; Giamouzis G, Skoularigis J, and Triposkiadis F revised the letter; All authors made substantial contributions to conception and design of the study, acquisition of data or analysis and interpretation of data, drafted the article or made critical revisions related to important intellectual content of the manuscript, and gave final approval of the version of the article to be published.
Conflict-of-interest statement: The authors declare no conflict of interest regarding the present work
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrew Xanthopoulos, FACC, MD, PhD, Doctor, Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. andrewvxanth@gmail.com
Received: November 11, 2021 Peer-review started: November 11, 2021 First decision: December 27, 2021 Revised: December 29, 2021 Accepted: March 16, 2022 Article in press: March 16, 2022 Published online: April 26, 2022 Processing time: 158 Days and 14.4 Hours
Abstract
Diabetes mellitus (DM) is a health condition characterized by glucose dysregulation and affects millions of people worldwide. The presentation of heart failure in diabetic cardiomyopathy extends over a wide phenotypic spectrum, commencing from asymptomatic, subclinical structural abnormalities to severely symptomatic biventricular dysfunction with increased mortality risk. Similarly, the spectrum of systolic dysfunction in diabetic-induced heart failure is diverse. DM leads also to cardiac electrical remodeling reacting on various targets. Dipeptidyl peptidase-4 (DPP-4) inhibitors reduce glucagon and blood glucose levels by raising levels of the endogenous hormones glucagon-like-peptide 1 and glucose-dependent insulinotropic peptide and constitute a safe and effective glucose lowering treatment option in patients with type 2 DM. Despite DPP-4 inhibitors’ efficacy regarding glycemic control, their effect on cardiovascular outcomes (myocardial infarction, stroke, hospitalization for heart failure, hospitalization for unstable angina, hospitalization for coronary revascularization, and cardiovascular death) in diabetic patients has been neutral. The potential correlation between atrial flutter and DPP-4 inhibitors administration needs further investigation.
Core Tip: Dipeptidyl peptidase-4 inhibitors are a safe and effective glucose lowering treatment option in patients with type 2 diabetes mellitus. However, their effect on cardiovascular outcomes in diabetic patients has been neutral. The potential correlation between atrial flutter and dipeptidyl peptidase-4 inhibitors administration is an interesting finding, but since currently there is no sheer underlying pathophysiologic mechanism to justify it, more evidence is required.
