#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Hypolipidemic treatment in the prevention of atherosclerosis in diabetic patients


Authors: Ľubomíra Fábryová 1,2,3
Authors‘ workplace: MetabolKLINIK s. r. o., Ambulancia pre diabetológiu, poruchy látkovej premeny a výživy, MED PED centrum, Bratislava 1;  Biomedicínske centrum Slovenskej Akadémie Vied, Bratislava 2;  Ústav zdravotníckych disciplín, Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety, Bratislava 3
Published in: Forum Diab 2021; 10(Supplementum 1): 28-36
Category:

Overview

Diabetes mellitus is a major cardiometabolic disease and is one of the main causes of premature development of atherosclerosis-related cardiovascular disease (AS CVD) in both sexes: myocardial infarction, stroke, need for revascularization and peripheral vascular disease. The incidence of cardiovascular diseases is high in type 2 diabetic patients in Slovakia (approximately 37 %) and is higher compared to Europe (30 %) as well as the world (32.2 %). The development of AS CVD in diabetics is conditioned not only by glycemic compensation, the duration of the disease, but especially by the presence of coexisting risk factors, including lipid and lipoprotein metabolism disorders. Current clinical practice should focus on more aggressive hypolipidemic treatment of high-risk diabetic patients in order to reduce CV morbidity and mortality. The review article provides an overview of our current possibilities of hypolipidemic therapy in diabetic patients, as well as hypolipidemic therapy in the near future.

Keywords:

bempedoic acid – cardiovascular risk categories – diabetic dyslipidemia – ezetimibe – fibrates – inclisiran – omega 3 fatty acids – PCSK9 inhibitors – pemafibrate – primary and secondary targets – statins


Sources
  1. Virani SS, Alonso A, Benjamin EJ et al. Heart Disease and Stroke Statistics—2020 Update: Summary. Circulation 2020; 141(9): e139-e596. Dostupné z DOI: <http://dx.doi.org/10.1161/CIR.00000000000007>.
  2. Zdravotnícka ročenka Slovenskej republiky 2019. Národné centrum zdravotníckych informácií: Bratislava 2021. ISBN 978–80–89292–77–6.
  3. Bruemmer D, Nissen SE. Prevention and management of cardiovascular disease in patients with diabetes: current challenges and opportunities. Cardiovasc Endocrinol Metab 2020; 9(3): 81–89. Dostupné z DOI: <http://dx.doi.org/10.1097/XCE.0000000000000199>.
  4. Sarwar N, Gao P, Kondapally Seshasai SR et al. Emerging Risk Factors Collaboration; Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 2010; 375(9733): 2215–2222. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(10)60484–9>.
  5. Aronson D, Edelman ER. Coronary artery disease and diabetes mellitus. Cardiol Clin. 2014;32(3):439–455. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ccl.2014.04.001>.
  6. Martinka E. Implementujeme aktuálne odporúčania ADA/EASD do liečby pacientov s diabetes mellitus 2. typu dostatočne? Forum Diab 2019; 8(2): 63–70.
  7. Mach F, Baigent C, Catapano AL et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Atherosclerosis. 2019; 290: 140–205. Dostupné z DOI: <http://dx.doi.org/10.1016/j.atherosclerosis.2019.08.014>.
  8. Cosentino F. Grant PJ, Aboyans V et al. 2019 Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases developed in collaboration with the EASD. Eur Heart J 2020; 41(2): 255–323. Dostupné z DOI: <https://doi.org/10.1093/eurheartj/ehz486>.
  9. [American Diabetes Association]. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2021. Diabetes Care 2021; 44(Suppl 1): S125-S150. Dostupné z DOI: <https://doi.org/10.2337/dc21-S010>.
  10. Fábryová Ľ. Martinka E, Murín J. Comment on the 2019 ESC/EASD Guidelines on diabetes, pre-diabetes and cardiovascular diseases. Cardiol Lett 2020; 29(4), 205–212. Dostupné z DOI: <http://dx.doi.org/10.4149/Cardiol_2020_4_1>.
  11. Fábryová Ľ. Aterogénna dyslipidémia – nový cieľ v kardiovaskulárnej prevencii. AtheroRew 2016; 3(1): 126- 137.
  12. Gupta M, Tummala R, Ghosh RK et al. An update on pharmacotherapies in diabetic dyslipidemia. Prog Cardiovasc Dis. 2019; 62(4): 334–341. Dostupné z DOI: <http://dx.doi.org/10.1016/j.pcad.2019.07.006>.
  13. Kearney PM, Blackwell L, Collins R et al. [Cholesterol Treatment Trialists Collaboration]. Efficacy of cholesterol lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet 2008; 371(9607): 117–125. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(08)60104-X>.
  14. Rawshani A, Sattar N, Franzen S et al. Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register-based cohort study. Lancet 2018; 392(10146): 477–486. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(18)31506-X>.
  15. Marcovecchio ML, Chiesa ST, Bond S et al. ACE inhibitors and statins in adolescents with type 1 diabetes. N Engl J Med 2017; 377(18): 1733–1745. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1703518>.
  16. Cannon CP, Blazing MA, Giugliano RP et al. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med 2015; 372(25): 2387–2397. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1410489>.
  17. Giugliano RP, Cannon CP, Blazing MA et al. Benefit of adding ezetimibe to statin therapy on cardiovascular outcomes and safety in patients with versus without diabetes mellitus: results from IMPROVE-IT (Improved reduction of outcomes: Vytorin efficacy international trial). Circulation 2018; 137(15): 1571–1582. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.117.030950>.
  18. Lorenzi M, Ambegaonkar B, Baxter CA et al. Ezetimibe in high-risk, previously treated statin patients: a systematic review and network meta-analysis of lipid efficacy. Clin Res Cardiol 2019; 108(5): 487–509. <http://dx.doi.org/10.1007/s00392–018–1379-z>.
  19. Arbel R, Hammerman A, Azuri J. Usefulness of ezetimibe versus evolocumab as add on therapy for secondary prevention of cardiovascular events in patients with type 2 diabetes mellitus. Am J Cardiol 2019; 123(8): 1273–1276. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjcard.2019.01.021>.
  20. Sabatine MS, Giugliano RP, Keech AC et al. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med 2017; 376(18): 1713–1722. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1615664>.
  21. Sabatine MS, Leiter LA, Wiviott SD et al. Cardiovascular safety and efficacy of the PCSK9 inhibitor evolocumab in patients with and without diabetes and the effect of evolocumab on glycaemia and risk of new-onset diabetes: a prespecified analysis of the FOURIER randomised controlled trial. Lancet Diabetes Endocrinol 2017; 5(12): 941–950. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(17)30313–3>.
  22. Rosenson RS, Daviglus ML, Handelsman Y et al. Efficacy and safety of evolocumab in individuals with type 2 diabetes mellitus: primary results of the randomised controlled BANTING study. Diabetologia 2019; 62(6): 948–958. Dostupné z DOI: <https://doi.org/10.1007/s00125–019–4856–7>.
  23. Lorenzatti AJ, Eliaschewitz FG, Chen Y et al. Randomised study of evolocumab in patients with type 2 diabetes and dyslipidaemia on background statin: Primary results of the BERSON clinical trial. Diabetes Obes Metab 2019; 21(6): 1455–1463. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.13680>.
  24. Schwartz GG, Steg PG, Szarek M et al. Alirocumab and cardiovascular outcomes after acute coronary syndrome. N Engl J Med 2018; 379(22): 2097–2107. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1801174>.
  25. Ray KK, Colhoun HM, Szarek M. et al. [ODYSSEY OUTCOMES Committees and Investigators]. Effects of alirocumab on cardiovascular and metabolic outcomes after acute coronary syndrome in patients with or without diabetes: a prespecified analysis of the ODYSSEY OUTCOMES randomised controlled trial. Lancet Diabetes Endocrinol 2019; 7(8): 618–628. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(19)30158–5>.
  26. Cao ZX, Zhang HW, Jin JL et al. The longitudinal association of remnant cholesterol with cardiovascular outcomes in patients with diabetes and prediabetes. Cardiovasc Diabetol 2020; 19(1):104. Dostupné z DOI: <https://doi.org/10.1186/s12933–020–01076–7>.
  27. Chait A, Ginsberg HN, Vaisar T et al. Remnants of the Triglyceride-Rich Lipoproteins, Diabetes and Cardiovascular Disease. Diabetes 2020; 69(4): 508–516. Dostupné z DOI: <https://doi.org/10.2337/dbi19–0007>.
  28. Sandesara PB, Virani SS, Fazio S et al. The forgotten lipids: triglycerides, remnant cholesterol, and atherosclerotic cardiovascular disease risk. Endocr Rev 2019; 40(2): 537–557. Dostupné z DOI: <http://dx.doi.org/10.1210/er.2018–00184>
  29. Bhatt DL, Steg PG, Miller M et al. [REDUCE-IT Investigators]. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med 2019; 380(1): 11–22. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1812792>.
  30. Tkáč I. Perspektívy v liečbe dyslipoproteinémií pri diabete. Forum Diab 2019; 8(2): 12–15.
  31. Nicholls SJ, Lincoff AM, Garcia M et al. Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk: The STRENGTH Randomized Clinical Trial. JAMA 2020; 324(22): 2268–2280. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2020.22258>.
  32. Marston NA, Giugliano RP, KyungAh I et al. Association Between Triglyceride Lowering and Reduction of Cardiovascular Risk Across Multiple Lipid-Lowering Therapeutic Classes A Systematic Review and Meta-Regression Analysis of Randomized Controlled Trials. Circulation 2019; 140(16): 1308–1317. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.119.041998>.
  33. Pradhan AD, Paynter NP, Everett BM et al. Rationale and design of the Pemafibrate to Reduce Cardiovascular Outcomes by Reducing Triglycerides in Patients with Diabetes (PROMINENT) study. Am Heart J 2018; 206: 80–93. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ahj.2018.09.011>.
  34. Wang X, Zhang Y, Tan H et al. Efficacy and safety of bempedoic acid for prevention of cardiovascular events and diabetes: a systematic review and meta-analysis. Cardiovasc Diabetol 2020; 19(1): 128. <https://doi.org/10.1186/s12933–020–01101–9>.
  35. Leiter LA, Teoh H, Kallend D et al. Inclisiran lowers LDL-C and PCSK9 irrespective of diabetes status: the ORION-1 randomized clinical trial. Diabetes Care 2019; 42(1): 173–176. Dostupné z DOI: <http://dx.doi.org/10.2337/dc18–1491>.
  36. Stoekenbroek RM, Kallend D, Wijngaard PL et al. Inclisiran for the treatment of cardiovascular disease: the ORION clinical development program. Future Cardiol 2018; 14(6): 433–442. Dostupné z DOI: <http://dx.doi.org/10.2217/fca-2018–0067>.
  37. Chodorge M, Celeste AJ, Grimsby J et al. Engineering of a GLP-1 analogue peptide/anti-PCSK9 antibody fusion for type 2 diabetes treatment. Sci Rep 2018; 8(1): 17545. Dostupné z DOI: <https://doi.org/10.1038/s41598–018–35869–4>.
  38. Fábryová Ľ. Adipozopatická dyslipidémia. In: Fábryová Ľ, Holéczy P (eds) et al. Diabezita. Diabetes a obezita: nerozlučné dvojičky. Facta Medica: Brno 2019: 209–223. ISBN 978–80–88056–09–6.
Labels
Diabetology Endocrinology Internal medicine
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#