Skip to main content
Erschienen in: Wiener klinische Wochenschrift 1/2019

12.04.2019 | leitlinien für die praxis

Diabetes mellitus, koronare Herzkrankheit und Herzinsuffizienz (Update 2019)

verfasst von: Martin Clodi, Christoph H. Saely, Friedrich Hoppichler, Michael Resl, Clemens Steinwender, Harald Stingl, Thomas C. Wascher, Yvonne Winhofer-Stöckl, Harald Sourij

Erschienen in: Wiener klinische Wochenschrift | Sonderheft 1/2019

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die Zusammenhänge zwischen Diabetes mellitus, koronarer Herzkrankheit und Herzinsuffizienz sind wechselseitig. Bei Erstmanifestation einer koronaren Herzkrankheit sollte aktiv auf Diabetes mellitus gescreent werden, während bei an Diabetes mellitus erkrankten Patienten die kardiovaskuläre Risikostratifizierung immer in Zusammenschau sämtlicher Risikofaktoren, Biomarker und dem klinischen Befinden des Patienten durchgeführt werden sollte. Eine bereits bekannte kardiovaskuläre Erkrankung wie auch das Vorliegen zahlreicher Risikofaktoren stellen wesentliche Kriterien für die Auswahl der individuellen Therapiestrategien dar. Derzeit liegen für Empagliflozin, Canagliflozin, Dapagliflozin, Pioglitazon, Semaglutid und Liraglutid positive kardiovaskuläre Ergebnisse aus Endpunktstudien vor.
Literatur
1.
Zurück zum Zitat Saely CH, et al. Key role of postchallenge hyperglycemia for the presence and extent of coronary atherosclerosis: an angiographic study. Atherosclerosis. 2008;199(2):317–22.CrossRef Saely CH, et al. Key role of postchallenge hyperglycemia for the presence and extent of coronary atherosclerosis: an angiographic study. Atherosclerosis. 2008;199(2):317–22.CrossRef
2.
Zurück zum Zitat Davis TM, et al. Prognostic significance of silent myocardial infarction in newly diagnosed type 2 diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS) 79. Circulation. 2013;127(9):980–7.CrossRef Davis TM, et al. Prognostic significance of silent myocardial infarction in newly diagnosed type 2 diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS) 79. Circulation. 2013;127(9):980–7.CrossRef
3.
Zurück zum Zitat Seferovic PM, et al. Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20(5):853–72.CrossRef Seferovic PM, et al. Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20(5):853–72.CrossRef
4.
Zurück zum Zitat Iribarren C, et al. Glycemic control and heart failure among adult patients with diabetes. Circulation. 2001;103(22):2668–73.CrossRef Iribarren C, et al. Glycemic control and heart failure among adult patients with diabetes. Circulation. 2001;103(22):2668–73.CrossRef
5.
Zurück zum Zitat Mosterd A, et al. The prognosis of heart failure in the general population: the Rotterdam Study. Eur Heart J. 2001;22(15):1318–27.CrossRef Mosterd A, et al. The prognosis of heart failure in the general population: the Rotterdam Study. Eur Heart J. 2001;22(15):1318–27.CrossRef
6.
Zurück zum Zitat Marwick TH. Diabetic heart disease. Heart. 2006;92(3):296–300.PubMed Marwick TH. Diabetic heart disease. Heart. 2006;92(3):296–300.PubMed
7.
Zurück zum Zitat Ponikowski P, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129–200.CrossRef Ponikowski P, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129–200.CrossRef
8.
Zurück zum Zitat Huo L, et al. Burden of diabetes in Australia: life expectancy and disability-free life expectancy in adults with diabetes. Diabetologia. 2016;59(7):1437–45.CrossRef Huo L, et al. Burden of diabetes in Australia: life expectancy and disability-free life expectancy in adults with diabetes. Diabetologia. 2016;59(7):1437–45.CrossRef
9.
Zurück zum Zitat Group BDS, et al. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med. 2009;360(24):2503–15.CrossRef Group BDS, et al. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med. 2009;360(24):2503–15.CrossRef
10.
Zurück zum Zitat Huelsmann M, et al. NT-proBNP has a high negative predictive value to rule-out short-term cardiovascular events in patients with diabetes mellitus. Eur Heart J. 2008;29(18):2259–64.CrossRef Huelsmann M, et al. NT-proBNP has a high negative predictive value to rule-out short-term cardiovascular events in patients with diabetes mellitus. Eur Heart J. 2008;29(18):2259–64.CrossRef
11.
Zurück zum Zitat Wackers FJ, et al. Detection of silent myocardial ischemia in asymptomatic diabetic subjects: the DIAD study. Diabetes Care. 2004;27(8):1954–61.CrossRef Wackers FJ, et al. Detection of silent myocardial ischemia in asymptomatic diabetic subjects: the DIAD study. Diabetes Care. 2004;27(8):1954–61.CrossRef
12.
Zurück zum Zitat Budoff MJ, et al. Noninvasive cardiovascular risk assessment of the asymptomatic diabetic patient: the imaging council of the American College of Cardiology. JACC Cardiovasc Imaging. 2016;9(2):176–92.CrossRef Budoff MJ, et al. Noninvasive cardiovascular risk assessment of the asymptomatic diabetic patient: the imaging council of the American College of Cardiology. JACC Cardiovasc Imaging. 2016;9(2):176–92.CrossRef
13.
Zurück zum Zitat Raggi P. Atherosclerosis imaging to refine cardiovascular risk assessment in diabetic patients: computed tomography and positron emission tomography applications. Atherosclerosis. 2018;271:77–83.CrossRef Raggi P. Atherosclerosis imaging to refine cardiovascular risk assessment in diabetic patients: computed tomography and positron emission tomography applications. Atherosclerosis. 2018;271:77–83.CrossRef
14.
Zurück zum Zitat Marso SP, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311–22.CrossRef Marso SP, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311–22.CrossRef
15.
Zurück zum Zitat Marso SP, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375(19):1834–44.CrossRef Marso SP, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375(19):1834–44.CrossRef
16.
Zurück zum Zitat Pfeffer MA, et al. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N Engl J Med. 2015;373(23):2247–57.CrossRef Pfeffer MA, et al. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N Engl J Med. 2015;373(23):2247–57.CrossRef
17.
Zurück zum Zitat Holman RR, Bethel MA, Hernandez AF. Once-weekly exenatide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2017;377(25):2502.CrossRef Holman RR, Bethel MA, Hernandez AF. Once-weekly exenatide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2017;377(25):2502.CrossRef
18.
Zurück zum Zitat Zinman B, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373:2117–2128.CrossRef Zinman B, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373:2117–2128.CrossRef
19.
Zurück zum Zitat Neal B, Perkovic V, Matthews DR. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017;377(21):2099.PubMed Neal B, Perkovic V, Matthews DR. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017;377(21):2099.PubMed
20.
Zurück zum Zitat Wiviott SD, et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019;380:347–357.CrossRef Wiviott SD, et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019;380:347–357.CrossRef
21.
Zurück zum Zitat Duckworth W, et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360(2):129–39.CrossRef Duckworth W, et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360(2):129–39.CrossRef
22.
Zurück zum Zitat Group AC, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358(24):2560–72.CrossRef Group AC, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358(24):2560–72.CrossRef
23.
Zurück zum Zitat Action to Control Cardiovascular Risk in Diabetes Study G, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358(24):2545–59.CrossRef Action to Control Cardiovascular Risk in Diabetes Study G, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358(24):2545–59.CrossRef
24.
Zurück zum Zitat Hayward RA, et al. Follow-up of glycemic control and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2015;373(10):978.PubMed Hayward RA, et al. Follow-up of glycemic control and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2015;373(10):978.PubMed
25.
Zurück zum Zitat Investigators OT, et al. Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med. 2012;367(4):319–28.CrossRef Investigators OT, et al. Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med. 2012;367(4):319–28.CrossRef
26.
Zurück zum Zitat Marso SP, et al. Efficacy and safety of degludec versus glargine in type 2 diabetes. N Engl J Med. 2017;377(8):723–32.CrossRef Marso SP, et al. Efficacy and safety of degludec versus glargine in type 2 diabetes. N Engl J Med. 2017;377(8):723–32.CrossRef
27.
Zurück zum Zitat Dormandy JA, et al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet. 2005;366(9493):1279–89.CrossRef Dormandy JA, et al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet. 2005;366(9493):1279–89.CrossRef
28.
Zurück zum Zitat Vaccaro O, et al. Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial. Lancet Diabetes Endocrinol. 2017;5(11):887–97.CrossRef Vaccaro O, et al. Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial. Lancet Diabetes Endocrinol. 2017;5(11):887–97.CrossRef
29.
Zurück zum Zitat Zoungas S, et al. Severe hypoglycemia and risks of vascular events and death. N Engl J Med. 2010;363(15):1410–8.CrossRef Zoungas S, et al. Severe hypoglycemia and risks of vascular events and death. N Engl J Med. 2010;363(15):1410–8.CrossRef
30.
Zurück zum Zitat Andersson C, et al. Metformin treatment is associated with a low risk of mortality in diabetic patients with heart failure: a retrospective nationwide cohort study. Diabetologia. 2010;53(12):2546–53.CrossRef Andersson C, et al. Metformin treatment is associated with a low risk of mortality in diabetic patients with heart failure: a retrospective nationwide cohort study. Diabetologia. 2010;53(12):2546–53.CrossRef
31.
Zurück zum Zitat Evans JM, et al. Effect of metformin on mortality in patients with heart failure and type 2 diabetes mellitus. Am J Cardiol. 2010;106(7):1006–10.CrossRef Evans JM, et al. Effect of metformin on mortality in patients with heart failure and type 2 diabetes mellitus. Am J Cardiol. 2010;106(7):1006–10.CrossRef
32.
Zurück zum Zitat Cefalu WT, et al. Cardiovascular outcomes trials in type 2 diabetes: where do we go from here? Reflections from a diabetes care editors’ expert forum. Diabetes Care. 2018;41(1):14–31.CrossRef Cefalu WT, et al. Cardiovascular outcomes trials in type 2 diabetes: where do we go from here? Reflections from a diabetes care editors’ expert forum. Diabetes Care. 2018;41(1):14–31.CrossRef
Metadaten
Titel
Diabetes mellitus, koronare Herzkrankheit und Herzinsuffizienz (Update 2019)
verfasst von
Martin Clodi
Christoph H. Saely
Friedrich Hoppichler
Michael Resl
Clemens Steinwender
Harald Stingl
Thomas C. Wascher
Yvonne Winhofer-Stöckl
Harald Sourij
Publikationsdatum
12.04.2019
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe Sonderheft 1/2019
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-019-1488-3

Weitere Artikel der Sonderheft 1/2019

Wiener klinische Wochenschrift 1/2019 Zur Ausgabe