Hormonal
SGLT2 inhibitors (specifically empagliflozin) reduce major adverse cardiovascular events (MACE) and cardiovascular death in patients with Type 2 Diabetes and established cardiovascular disease.
If you have Type 2 Diabetes and established cardiovascular disease, empagliflozin (10 or 25 mg daily) can significantly reduce your risk of major cardiovascular events and cardiovascular death. This benefit is observed even in patients with moderately reduced kidney function (eGFR > 30). The mechanism is likely related to hemodynamic changes rather than just glucose lowering.
empagliflozin significantly (albeit by a small margin) improved the occurrence of the primary major adverse cardiovascular event outcome of the trial (cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke) by 14% compared with placebo (hazard ratio [HR], 0.86; 95% confidence interval [95% CI], 0.74 to 0.99; P50.04), which was mainly driven by a significant 38% reduction in cardiovascular death (HR, 0.62; 95% CI, 0.49 to 077; P,0.001) (6).
Why this rating
Based on the large, randomized, placebo-controlled EMPA-REG OUTCOME trial.
Source
SGLT2 Inhibition in the Diabetic Kidney—From Mechanisms to Clinical Outcome
Erik J.M. van Bommel et al. · Clinical Journal of the American Society of Nephrology · 2017
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