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18.04.2024 | Diabetes and Cardiovascular Disease (D Bruemmer, Section Editor)

Unexplained Residual Risk In Type 2 Diabetes: How Big Is The Problem?

verfasst von: Sivaram Neppala, Jemema Rajan, Eric Yang, Ralph A. DeFronzo

Erschienen in: Current Cardiology Reports

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Abstract

Purpose of Review

What is new? Cardiovascular disease (CVD) is the leading cause of mortality in type 2 diabetes (T2D) individuals. Of the major risk factors for CVD, less than 10% of T2D people meet the American Diabetes Association/American Heart Association recommended goals of therapy. The present review examines how much of the absolute cardiovascular (CV) risk in type 2 diabetes patients can be explained by major CV intervention trials.

Recent Findings

Multiple long-term cardiovascular (CV) intervention trials have examined the effect of specific target-directed therapies on the MACE endpoint. Only one prospective study, STENO-2, has employed a multifactorial intervention comparing intensified versus conventional treatment of modifiable risk factors in T2D patients, and demonstrated a 20% absolute CV risk reduction.

Summary

If the absolute CV risk reduction in these trials is added to that in the only prospective multifactorial intervention trial (STENO-2), the unexplained CV risk is 44.1%.

What are the clinical implications?

Potential explanations for the unaccounted-for reduction in absolute CV risk in type 2 diabetes (T2D) patients are discussed.
Hypothesis: failure to take into account synergistic interactions between major cardiovascular risk factors is responsible for the unexplained CV risk in T2D patients.
Simultaneous treatment of all major CV risk factors to recommended AHA/ADA guideline goals is required to achieve the maximum reduction in CV risk.

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Titel: Unexplained Residual Risk In Type 2 Diabetes: How Big Is The Problem?
verfasst von: Sivaram Neppala
Jemema Rajan
Eric Yang
Ralph A. DeFronzo
Publikationsdatum: 18.04.2024
Verlag: Springer US
Erschienen in: Current Cardiology Reports
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI: https://doi.org/10.1007/s11886-024-02055-0

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Unexplained Residual Risk In Type 2 Diabetes: How Big Is The Problem?

Abstract

Purpose of Review

Recent Findings

Summary

Neu im Fachgebiet Kardiologie

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

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Live-Webinar "Urologie und Sexualmedizin in der Praxis"

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Abstract

Purpose of Review

Recent Findings

Summary

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Neu im Fachgebiet Kardiologie

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

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