Systematic Review of Cardiovascular Outcomes with Sulfonylureas, GLP-1 RA, and DPP-4 Inhibitors in Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) significantly increases the risk of cardiovascular diseases. Despite advances in glycemic control, managing cardiovascular risk remains a critical challenge. This systematic review aims to assess and compare the cardiovascular outcomes associated with three classes of...

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Main Authors: Koo Thai Hau, Mohamed Mafauzy, Leong Xue Bin
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-07-01
Series:Journal of Diabetology
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Online Access:https://journals.lww.com/jodb/fulltext/2024/15030/systematic_review_of_cardiovascular_outcomes_with.4.aspx
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author Koo Thai Hau
Mohamed Mafauzy
Leong Xue Bin
author_facet Koo Thai Hau
Mohamed Mafauzy
Leong Xue Bin
author_sort Koo Thai Hau
collection DOAJ
description Type 2 diabetes mellitus (T2DM) significantly increases the risk of cardiovascular diseases. Despite advances in glycemic control, managing cardiovascular risk remains a critical challenge. This systematic review aims to assess and compare the cardiovascular outcomes associated with three classes of antidiabetic medications: sulfonylureas, Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and dipeptidyl peptidase-4 inhibitors (DPP-4i) in patients with T2DM. A systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases, including PubMed, Embase, Cochrane Library, and Google Scholar, were searched for relevant studies published between 2019 and 2023. Inclusion criteria were adults (≥18 years) with T2DM, studies assessing cardiovascular outcomes with the specified medications, randomized controlled trials, observational studies, or meta-analyses. Two independent reviewers performed data extraction and risk of bias assessments. From the initial 1,543 records, 12 studies were included involving 61,534 patients. As a result, GLP-1 RAs demonstrated favorable cardiovascular safety and efficacy, particularly in reducing major adverse cardiovascular events and all-cause mortality. DPP-4 inhibitors were associated with neutral cardiovascular outcomes but indicated an elevated risk of cardiac failure in some studies. In recent studies, sulfonylureas, previously associated with cardiovascular concerns, showed no consistent evidence of increased cardiovascular risk. These findings highlight the importance of personalized treatment strategies to optimize cardiovascular outcomes in patients with T2DM.
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spelling doaj-art-b7c2ebe1b6e646c58c45166dd63c83612025-08-20T02:09:55ZengWolters Kluwer Medknow PublicationsJournal of Diabetology2078-76852024-07-0115326627210.4103/jod.jod_80_24Systematic Review of Cardiovascular Outcomes with Sulfonylureas, GLP-1 RA, and DPP-4 Inhibitors in Type 2 Diabetes MellitusKoo Thai HauMohamed MafauzyLeong Xue BinType 2 diabetes mellitus (T2DM) significantly increases the risk of cardiovascular diseases. Despite advances in glycemic control, managing cardiovascular risk remains a critical challenge. This systematic review aims to assess and compare the cardiovascular outcomes associated with three classes of antidiabetic medications: sulfonylureas, Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and dipeptidyl peptidase-4 inhibitors (DPP-4i) in patients with T2DM. A systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases, including PubMed, Embase, Cochrane Library, and Google Scholar, were searched for relevant studies published between 2019 and 2023. Inclusion criteria were adults (≥18 years) with T2DM, studies assessing cardiovascular outcomes with the specified medications, randomized controlled trials, observational studies, or meta-analyses. Two independent reviewers performed data extraction and risk of bias assessments. From the initial 1,543 records, 12 studies were included involving 61,534 patients. As a result, GLP-1 RAs demonstrated favorable cardiovascular safety and efficacy, particularly in reducing major adverse cardiovascular events and all-cause mortality. DPP-4 inhibitors were associated with neutral cardiovascular outcomes but indicated an elevated risk of cardiac failure in some studies. In recent studies, sulfonylureas, previously associated with cardiovascular concerns, showed no consistent evidence of increased cardiovascular risk. These findings highlight the importance of personalized treatment strategies to optimize cardiovascular outcomes in patients with T2DM.https://journals.lww.com/jodb/fulltext/2024/15030/systematic_review_of_cardiovascular_outcomes_with.4.aspxcardiovascular disease; dipeptidyl peptidase-4 inhibitors; glucagon-like peptide-1 receptor agonists; sulfonylureas; type 2 diabetes mellitus
spellingShingle Koo Thai Hau
Mohamed Mafauzy
Leong Xue Bin
Systematic Review of Cardiovascular Outcomes with Sulfonylureas, GLP-1 RA, and DPP-4 Inhibitors in Type 2 Diabetes Mellitus
Journal of Diabetology
cardiovascular disease; dipeptidyl peptidase-4 inhibitors; glucagon-like peptide-1 receptor agonists; sulfonylureas; type 2 diabetes mellitus
title Systematic Review of Cardiovascular Outcomes with Sulfonylureas, GLP-1 RA, and DPP-4 Inhibitors in Type 2 Diabetes Mellitus
title_full Systematic Review of Cardiovascular Outcomes with Sulfonylureas, GLP-1 RA, and DPP-4 Inhibitors in Type 2 Diabetes Mellitus
title_fullStr Systematic Review of Cardiovascular Outcomes with Sulfonylureas, GLP-1 RA, and DPP-4 Inhibitors in Type 2 Diabetes Mellitus
title_full_unstemmed Systematic Review of Cardiovascular Outcomes with Sulfonylureas, GLP-1 RA, and DPP-4 Inhibitors in Type 2 Diabetes Mellitus
title_short Systematic Review of Cardiovascular Outcomes with Sulfonylureas, GLP-1 RA, and DPP-4 Inhibitors in Type 2 Diabetes Mellitus
title_sort systematic review of cardiovascular outcomes with sulfonylureas glp 1 ra and dpp 4 inhibitors in type 2 diabetes mellitus
topic cardiovascular disease; dipeptidyl peptidase-4 inhibitors; glucagon-like peptide-1 receptor agonists; sulfonylureas; type 2 diabetes mellitus
url https://journals.lww.com/jodb/fulltext/2024/15030/systematic_review_of_cardiovascular_outcomes_with.4.aspx
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