Expert consensus on the practical aspects of the cooperation of cardiologist and diabetologist in the management of the patients with chronic heart failure and reduced ejection fraction
Authors:
Martin Haluzík 1; Markéta Kubíčková 2; Jiří Veselý 2,3; Aleš Linhart 4; Martin Prázný 5; Jan Škrha 5; Miloš Táborský 6; Filip Málek 7,8
Authors‘ workplace:
Centrum diabetologie IKEM, Praha
1; III. interní gerontometabolická klinika, Fakultní nemocnice Hradec Králové a Univerzita Karlova – Lékařská, fakulta v Hradci Králové
2; EDUMED, s. r. o., Náchod
3; II. interní klinika Všeobecné fakultní nemocnice a 1. lékařské fakulty Univerzity Karlovy v Praze
4; III. interní klinika Všeobecné fakultní nemocnice a 1. lékařské fakulty Univerzity Karlovy v Praze
5; I. interní kardiologická klinika Fakultní nemocnice Olomouc a Lékařské fakulty Univerzity Palackého, Olomouc
6; Kardiologické oddělení Nemocnice Na Homolce, Praha
7; Interní klinika Fakultní nemocnice Královské Vinohrady a 3. lékařské fakulty Univerzity Karlovy v Praze
8
Published in:
Vnitř Lék 2021; 67(7): 404-411
Category:
Review Articles
Overview
Diabetes mellitus is an important risk factor for the development of heart failure and presence of diabetes significantly worsens heart failure outcome. Introduction of gliflozins to the therapy of heart failure is one of the most important novelty. Gliflozins reduce glucose level by the sodium-glucose contransporter 2 inhibition in proximal tubulus in the kidney. Gliflozins are used as effective antidiabetic drugs with improvement of glycemic control without risk of hypoglycemia, gliflozins decrease blood pressure and patients weight. Recent studies have shown that gliflozins significantly reduce risk of cardiovascular complications and heart failure hospitalizations in diabetic patients. Clinical trials with dapagliflozin and empagliflozin have shown reduction of the risk of cardiovascular death and heart failure hospitalization in the patients with heart failure and reduced ejection fraction both in the patients with diabetes and in the patients without diabetes. The aim of the expert consenzus is to summarize practical aspects in the cooperation of cardiologist and diabetologist in the management of the patients with heart failure and reduced ejection fraction in the context of the current guidelines and other treatment options.
Keywords:
type 2 diabetes mellitus – gliflozins – cardiovascular complications – heart failure with reduce ejection fraction
Sources
1. McDonagh TA, Metra M, Adamo M et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021.
2. Lam CSP, Butler J. Victims of Success in Failure. Circulation 2020; 142(12): 1129–1131.
3. Zinman B, Wanner C, Lachin JM et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015; 373(22): 2117–2128.
4. Wiviott SD, Raz I, Bonaca MP et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2019; 380(4): 347–357.
5. Neal B, Perkovic V, Mahaffey KW et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med 2017; 377(7): 644–657.
6. McMurray JJV, Solomon SD, Inzucchi SE et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med 2019; 381(21): 1995–2008.
7. Packer M, Anker SD, Butler J et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020; 383(15): 1413–1424.
8. Ponikowski P, Voors AA, Anker SD 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): 2129–2200.
9. PM, Ponikowski P, Anker SD et al. Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2019; 21(10): 1169–1186.
10. Writing C, Maddox TM, Januzzi JL, Jr. et al. 2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol 2021; 77(6): 772–810.
11. B, Coats AJS, Tsutsui H et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association. Eur J Heart Fail 2021; 23(3): 352–380.
12. F. Patofyziologie a diagnostika srdečního selhání. In: Táborský M KJ, Linhart A et al. Kardiologie, IV. Srdeční selhání. Česká kardiologická společnost, z.s. 2021: 634.
13. UK NICE guideline 106: Chronic heart failure in adults: diagnosis and management (12/12/2018), https://www.nice.org.uk/guidance/ng106.
14. Doporučený postup péče o diabetes mellitus 2. typu Za ČDS: J. Škrha TP, M. Prázný, M. Kvapil Revize ze dne: 31. 5. 2020 https://www.diab.cz/dokumenty/Standardy_DM.pdf.
15. American Diabetes A. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2021. Diabetes Care 2021; 44(Suppl 1): S111–S124.
16. Honigberg MC VO, Vaduganathan M. Practical Considerations for the Use of Sodium‑Glucose Co‑Transporter 2 Inhibitors in Heart Failure. Circ Heart Fail 2020 Feb; 13(2):e006623. doi: 10.1161/CIRCHEARTFAILURE.119.006623. Epub 2020 Feb 14. PMID: 32059632; PMCID: PMC7543063.
17. Špinar J, Málek F, Špinarová L, Vítovec J, Táborský M, Linhart A. Úprava guidelines ACC pro léčbu srdečního selhání v roce 2021 Cor et Vasa 2021; 63(2): 264–270 | DOI: 10.33678/ cor.2021.033.
18. Málek F, Melenovský V, Krejčí J et al. Stanovisko výboru České asociace srdečního selhání ČKS k organizaci ambulancí srdečního selhání. Cor Vasa 2020; 62: 309–313.
19. Engelhardt K, Ferguson M, Rosselli JL. Prevention and Management of Genital Mycotic Infections in the Setting of Sodium‑Glucose Cotransporter 2 Inhibitors. Ann Pharmacother 2021; 55(4): 543–548.
20. Táborský M, Skála T, Lazárová M et al. Trends in the treatment and survival of heart failure patients: a nationwide population‑based study in the Czech Republic. ESC Heart Failure 2021, DOI:10.1002/ehf2.13559.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2021 Issue 7
Most read in this issue
- Hereditary hemorrhagic telangiectasia (Osler‑Weber‑Rendu syndrome) – Part II. Pharmacological therapy and international guidelines for the therapy 2020
- Appropriate and inappropriate therapies of implantable cardioverter‑defibrillators
- Metabolic and endocrine diseases – is our approach always rational?
- First zero contrast PCI guided by intracoronary ultrasound in the Czech Republic