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Minerva Endocrinologica 2017 March;42(1):53-63

DOI: 10.23736/S0391-1977.16.02349-X

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Antidiabetic medications in patients with heart failure

Marylene M. SAMIA EL HAYEK, Maya F. BEYDOUN, Sami T. AZAR

Division of Endocrinology and Metabolism, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon


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Diabetes mellitus increases the mortality secondary to heart failure independent of hypertension and coronary artery disease. Several hypoglycemic agents are used to achieve glycemic control, of which several classes however still raise controversies in terms of safety in patients with concomitant heart failure: Metformin does not carry an increased risk of exacerbation in patients with stable heart failure, yet should be avoided in patients with unstable disease or chronic kidney disease. Sulfonylureas are neither associated with an increased mortality, nor do they seem to have deleterious effects on heart failure. Thiazolidinediones are relatively contraindicated in patients with New York Heart Association class III or IV disease secondary to concerns of fluid retention and heart failure exacerbation. Glucagon-like peptide 1 agonists have shown trends towards improvement of heart failure parameters. Dipeptidylpeptidase 4 inhibitors show an overall neutral outcome, although saxagliptin can possibly be associated with an increased risk of hospitalization for heart failure. The use of sodium-glucose co-transporter 2 inhibitors is associated with beneficial cardiovascular outcomes, and further studies are underway.


KEY WORDS: Diabetes mellitus - Hypoglycemic agents - Heart failure

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Publication History

Issue published online: January 5, 2017
Article first published online: May 19, 2016
Manuscript accepted: May 18, 2016
Manuscript revised: April 29, 2016
Manuscript received: March 23, 2015

Per citare questo articolo

Samia El Hayek MM, Beydoun MF, Azar ST. Antidiabetic medications in patients with heart failure. Minerva Endocrinol 2017;42:53-63. DOI: 10.23736/S0391-1977.16.02349-X

Corresponding author e-mail

sazar@aub.edu.l