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HF - An Elephant in the Room: Management in the Era of SGLT-2 Inhibitors

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Dr Sundar Mudaliar; San Diego, California    20 November 2018

  1.    Cardiovascular disease is more than MACE (MI, CVA, CV death).
  2. Heart failure is an important component of CVD.
  3. Heart failure (HF) is quite prevalent in patients with diabetes; occurs in >1 in 5 patients aged over 65 years.
  4. Patients with both diabetes and HF have a poor prognosis, with a median survival of ~4 years.
  5. Diabetes can lead to HF through both atherosclerotic-mediated and atherosclerotic-independent mechanisms.
  6. In a network meta-analysis, the use of SGLT-2i or glucagon-like peptide (GLP)-1 was associated with lower mortality in patients with T2DM.
  7. SGLT-2i have moderate benefits on atherosclerotic MACE in patients with established atherosclerotic cardiovascular disease (ASCVD). Additionally, they have robust benefits on reducing hospitalization for HF and progression of renal disease regardless of existing ASCVD or a history of HF.

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