EMPA-REG OUTCOME: The Endocrinologist's Point of View

The American Journal of Medicine
Leigh Perreault

Abstract

For many years, it was widely accepted that control of plasma lipids and blood pressure could lower macrovascular risk in patients with type 2 diabetes mellitus (T2DM), whereas the benefits of lowering plasma glucose were largely limited to improvements in microvascular complications. The Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients-Removing Excess Glucose (EMPA-REG OUTCOME) study demonstrated for the first time that a glucose-lowering agent, the sodium glucose cotransporter 2 (SGLT2) inhibitor empagliflozin, could reduce major adverse cardiovascular events, cardiovascular mortality, hospitalization for heart failure, and overall mortality when given in addition to standard care in patients with T2DM at high cardiovascular risk. These results were entirely unexpected and have led to much speculation regarding the potential mechanisms underlying cardiovascular benefits. In this review, the results of EMPA-REG OUTCOME are summarized and put into perspective for the endocrinologist who is treating patients with T2DM and cardiovascular disease.

References

Oct 23, 2002·Circulation·Milton PackerUNKNOWN Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) Study Group
May 23, 2007·The New England Journal of Medicine·Steven E Nissen, Kathy Wolski
Jun 10, 2008·The New England Journal of Medicine·Anushka PatelFlorence Travert
Jun 10, 2008·The New England Journal of Medicine·UNKNOWN Action to Control Cardiovascular Risk in Diabetes Study GroupWilliam T Friedewald
Dec 19, 2008·The New England Journal of Medicine·William DuckworthUNKNOWN VADT Investigators
Feb 12, 2013·American Journal of Physiology. Heart and Circulatory Physiology·David G CotterPeter A Crawford
Sep 3, 2013·The New England Journal of Medicine·Benjamin M SciricaUNKNOWN SAVOR-TIMI 53 Steering Committee and Investigators
Sep 3, 2013·The New England Journal of Medicine·William B WhiteUNKNOWN EXAMINE Investigators
Jan 28, 2014·The Journal of Clinical Investigation·Ele FerranniniHans-Juergen Woerle
Jun 9, 2015·The New England Journal of Medicine·Jennifer B GreenUNKNOWN TECOS Study Group
Nov 7, 2015·Journal of Diabetes and Its Complications·Ralph A DeFronzo
Nov 19, 2015·The Journal of Clinical Endocrinology and Metabolism·John P BilezikianNorm Rosenthal
Dec 3, 2015·The New England Journal of Medicine·Marc A PfefferUNKNOWN ELIXA Investigators
Jan 29, 2016·European Heart Journal·David FitchettUNKNOWN EMPA-REG OUTCOME® trial investigators
Mar 11, 2016·Nature Reviews. Cardiology·Itamar Raz, Avivit Cahn
May 22, 2016·Diabetes Care·Muhammad Abdul-GhaniRalph A DeFronzo
Nov 12, 2016·Diabetes Technology & Therapeutics·Jennifer M TrujilloMichael T McDermott
May 21, 2017·The American Journal of Medicine·James Thrasher

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