Cardiovascular Endocrinology & Metabolism最新文献

{"title":"Cardiometabolic medicine: a review of the current proposed approaches to revamped training in the United States.","authors":"Garshasb P Soroosh,&nbsp;Omar Dzaye,&nbsp;Cara Reiter-Brennan,&nbsp;Michael J Blaha","doi":"10.1097/XCE.0000000000000243","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000243","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) remains the leading cause of mortality in the United States, and the population of patients with cardiometabolic conditions, including obesity, metabolic syndrome and diabetes mellitus, continues to grow. There is a need for physicians with specific training in cardiometabolic medicine to provide a 'medical home' for patients with cardiometabolic disease, rather than the fractured care that currently exists in the United States. Cardiometabolic specialists will head multidisciplinary clinics, develop practice guidelines, and lead through research. Proposals for US training in cardiometabolic medicine include: maintain the current training model, a dedicated 2-3 year fellowship following internal medicine residency, a 1-year fellowship following either internal medicine residency or fellowship in cardiology or endocrinology, and certification available to any interested clinician. This review discusses the pros and cons of these approaches. The authors believe that a dedicated cardiometabolic training fellowship has significant advantages over the other options.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 3","pages":"168-174"},"PeriodicalIF":2.3,"publicationDate":"2021-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/12/xce-10-168.PMC8352603.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39307012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salivary markers and coronavirus disease 2019: insights from cross-talk between the oral microbiome and pulmonary and systemic low-grade inflammation and implications for vascular complications.","authors":"Antoine AbdelMassih,&nbsp;Alaa A Hassan,&nbsp;Aya S Abou-Zeid,&nbsp;Aya Hassan,&nbsp;Engy Hussein,&nbsp;Mahenar Gadalla,&nbsp;Mahinour Hussein,&nbsp;Maryam A Eid,&nbsp;Maryam Elahmady,&nbsp;Nadine El Nahhas,&nbsp;Nadine Emad,&nbsp;Nihal Zahra,&nbsp;Nour Aboushadi,&nbsp;Nourhan Ibrahim,&nbsp;Sherouk Mokhtar,&nbsp;Habiba-Allah Ismail,&nbsp;Nadine El-Husseiny,&nbsp;Reham Khaled Moharam,&nbsp;Esraa Menshawey,&nbsp;Rahma Menshawey","doi":"10.1097/XCE.0000000000000242","DOIUrl":"10.1097/XCE.0000000000000242","url":null,"abstract":"<p><p>To date, coronavirus disease 2019 (COVID-19) has affected over 6.2 million individuals worldwide, including 1.46 million deaths. COVID-19 complications are mainly induced by low-grade inflammation-causing vascular degeneration. There is an increasing body of evidence that suggests that oral dysbiotic taxa are associated with worse prognosis in COVID-19 patients, especially the Prevotella genus, which was retrieved from nasopharyngeal and bronchoalveolar lavage samples in affected patients. Oral dysbiosis may act by increasing the likelihood of vascular complications through low-grade inflammation, as well as impairing respiratory mucosal barrier mechanisms against SARS-CoV-2. Salivary markers can be used to reflect this oral dysbiosis and its subsequent damaging effects on and the lungs and vasculature. Salivary sampling can be self-collected, and is less costly and less invasive, and thus may be a superior option to serum markers in risk stratification of COVID-19 patients. Prospective studies are needed to confirm such hypothesis. Video Abstract: http://links.lww.com/CAEN/A28.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 3","pages":"162-167"},"PeriodicalIF":2.3,"publicationDate":"2021-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/59/xce-10-162.PMC8352626.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39306626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speckle tracking echocardiographic assessment of left ventricular longitudinal strain in female patients with subclinical hyperthyroidism.","authors":"Randa R Abdelrazk,&nbsp;Amr A El-Sehrawy,&nbsp;Mohamed G M Ghoniem,&nbsp;Maged Z Amer","doi":"10.1097/XCE.0000000000000241","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000241","url":null,"abstract":"<p><strong>Background: </strong>Patients with subclinical hypothyroidism (SCH) are subjected to many cardiac changes. However, these changes are of gradual onset and cannot be usually detected using conventional diagnostic methods. Speckle tracking echocardiography (STE) is capable to detect cardiac function alterations usually unidentified by conventional echocardiography. The present study aimed to evaluate the role of STE in the detection of early cardiac changes in female patients with SCH.</p><p><strong>Methods: </strong>The study included 33 female patients with SCH and 30 matched healthy volunteer women with normal thyroid functions who served as controls. Upon recruitment, all participants were subjected to careful history taking, thorough clinical examination and routine laboratory investigations, including thyroid-stimulating hormone and Free T4. The echocardiographic examination included conventional, color Doppler and two-dimensional STE.</p><p><strong>Results: </strong>Analysis of conventional echocardiographic data revealed that patients had significantly higher end-systolic volume when compared with controls. In addition, it was noted that SCH patients had significantly lower mitral E/A ratio, isovolumetric relaxation time and significantly higher left atrium volume index in comparison to controls. In respect to STE data, we noted that patients had significantly lower values of mid-anteroseptal, apical lateral, apical septal, apical apex, AP4L strain and global strain % when compared with controls.</p><p><strong>Conclusions: </strong>Patients with SCH have deteriorated global strain in comparison to healthy controls.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 3","pages":"182-185"},"PeriodicalIF":2.3,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/06/xce-10-182.PMC8352628.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39307015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel biomarkers for subtle myocardial involvement in type I diabetes mellitus.","authors":"Sonia A El-Saiedi,&nbsp;Mona H Hafez,&nbsp;Yasser M Sedky,&nbsp;Sahar A Sharaf,&nbsp;Mona S Kamel,&nbsp;Antoine F AbdelMassih","doi":"10.1097/XCE.0000000000000240","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000240","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of certain biomarkers could be used to predict left ventricular (LV) and right ventricular (RV) function impairment in children with type 1 diabetes mellitus. The aim of this study was to determine the best cardiac biomarker for prediction of diabetic cardiomyopathy.</p><p><strong>Methodology: </strong>This study was designed as case-control study. A total of 55 children with type 1 diabetes mellitus (group/G1) and 55 healthy controls (G2) were subjected to echocardiography including 3D-Speckle Tracking Echocardiography and tissue Doppler imaging for assessment of RV and LV systolic and diastolic functions. As well as HbA1c, troponin I, brain natriuretic peptide (BNP), plasma cardiotrophin (CT-1), activin-A, transforming growth factor-β, and human insulin-like growth factor binding protein-7 (IGFBP-7) measurements.</p><p><strong>Results: </strong>Diabetic patients showed RV and LV systo-diastolic dysfunction compared to controls, the best predictor of LV systolic dysfunction was CT-1 (sensitivity: 69%, while IGFBP-7 was found to be the best predictor of RV systolic dysfunction (sensitivity: 63%). BNP was found to the best predictor of diastolic RV and LV dysfunction (sensitivity: 82% for both).</p><p><strong>Conclusion: </strong>CT-1 has proven to be a diagnostic superiority in LV systolic dysfunction whilst BNP continues to prove every day through our study and through many others that it is the chief marker of diastolic dysfunction and HFpEF. This potential accuracy and the increasing availability of BNP in the outpatient setting make it clear that it should be used as a screening test for diabetic patients.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 3","pages":"175-181"},"PeriodicalIF":2.3,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39307014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of diastolic function in newly diagnosed hyperthyroid patients with preserved left ventricular systolic function.","authors":"Maryam Shojaeifard,&nbsp;Zahra Davoudi,&nbsp;Azam Erfanifar,&nbsp;Hamed Fattahi Neisiani,&nbsp;Sajad Erami,&nbsp;Hooman Bakhshandeh,&nbsp;Khadije Mohammadi","doi":"10.1097/XCE.0000000000000238","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000238","url":null,"abstract":"<p><strong>Background: </strong>Diastolic dysfunction has been reported as a cardiovascular effect of hyperthyroidism, and is also supposed to be a cause of heart failure manifestations in the patients with preserved ejection fraction (EF).</p><p><strong>Methods: </strong>For evaluation of diastolic function in hyperthyroid patients and also diastolic function during performing exercise stress echocardiography, we conducted this study on 25 newly diagnosed hyperthyroid patients compared to 26 healthy subjects as control group. Diastolic function of the patients at rest was assessed using these parameters as follows: left atrium volume index, tricuspid regurgitation (TR) velocity, mitral inflow early diastolic flow (E wave), tissue Doppler of mitral annular velocity (e'), E/e' ratio, and isovolumic relaxation time (IVRT); and during exercise stress echocardiography, we judged diastolic response by measuring E/e' ratio and TR velocity at the peak of stress.</p><p><strong>Results: </strong>The mean age of the patients was 39.64 ± 12.23 years old and 52% of them were female. History of exertional dyspnea was found in 64% of patients. All the patients had normal diastolic function at the time of resting and there was no significant difference in diastolic parameters between the two groups except for IVRT, which was lower in hyperthyroid patients. Interestingly, no patients developed diastolic dysfunction during exercise stress echocardiography.</p><p><strong>Conclusion: </strong>Our finding did not show diastolic dysfunction in hyperthyroid patients neither at rest nor during exercise echocardiography and did not support the hypothesis that diastolic dysfunction can be a cause of exertional intolerance and dyspnea in the patients with preserved EF.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 3","pages":"186-190"},"PeriodicalIF":2.3,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39307016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testosterone, HIV, and cardiovascular disease risk.","authors":"Jelani K Grant,&nbsp;Quentin Loyd,&nbsp;Claudia Martinez","doi":"10.1097/XCE.0000000000000236","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000236","url":null,"abstract":"<p><p>There has been a recent increase in the use of testosterone supplementation among young adults in the United States, despite the controversy of testosterone replacement therapy (TRT) and cardiovascular safety. The lower testosterone levels and earlier age of TRT use in persons living with HIV (PLHIV) is of particular relevance for this population because cardiovascular disease (CVD) comorbidities are known to be increased among PLHIV. There is very limited data on TRT in PLHIV, as such, in this article, we sought to compile current evidence regarding the diagnosis and management of testosterone deficiency and its link to CVD risk including among PLHIV.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 2","pages":"72-79"},"PeriodicalIF":2.3,"publicationDate":"2020-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/d9/xce-10-072.PMC8189608.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39092931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between plasma vitamin D level and heart valves calcification in acute coronary syndrome and non acute coronary syndrome patients.","authors":"Viktor Feldman,&nbsp;Avishag Laish-Farkash,&nbsp;Chaim Yosefy","doi":"10.1097/XCE.0000000000000235","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000235","url":null,"abstract":"<p><strong>Background: </strong>There is conflicting data regarding the association between low levels of plasma vitamin D and ischemic heart disease. We aimed to investigate the relationship between plasma vitamin D levels and heart valve calcification in hospitalized patients with ischemic heart disease versus non-ischemic heart disease controls.</p><p><strong>Methods: </strong>A prospective case-control study comprising two age and gender-matched groups. The study group included consecutive patients hospitalized due to acute coronary syndrome; the control group included consecutive non-ischemic heart disease patients hospitalized for noncardiac causes. Blood samples for 25-hydroxyvitamin D level were drawn. An echocardiogram was performed during the first 3 days of hospitalization and reviewed for presence and degree of valvular calcification.</p><p><strong>Results: </strong>Forty patients with acute coronary syndrome and 40 controls (age 58 ± 11 years, 64% male in both groups) were included. Mean plasma 25-hydroxyvitamin D vitamin level in the entire cohort was 24.5 ± 8 ng/ml. Valve calcification rates were similar in acute coronary syndrome versus non-acute coronary syndrome group (28 vs. 21 had valvular calcification; 18 vs. 12 had aortic valve calcification; 21 vs. 14 had mitral valve calcification, respectively; <i>P</i> = NS for all). We found no significant relationship between vitamin D level and valvular calcification, aortic valve calcification, or mitral valve calcification rate or degree in the entire cohort and in each group alone (<i>P</i> = NS for all). There was a negative correlation between 25-hydroxyvitamin D levels and age in the acute coronary syndrome group (<i>r</i> = -0.399, <i>P</i> = 0.012).</p><p><strong>Conclusions: </strong>We did not find a significant relationship between plasma vitamin D levels and the rate or degree of calcification of either aortic/mitral/both valves in hospitalized patients with or without ischemic heart disease.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 2","pages":"113-119"},"PeriodicalIF":2.3,"publicationDate":"2020-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186514/pdf/xce-10-113.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39100977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 pandemic: a glimpse into newly diagnosed hypertensive patients.","authors":"Ertan Yetkin,&nbsp;Gökay Taylan,&nbsp;Kenan Yalta","doi":"10.1097/XCE.0000000000000234","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000234","url":null,"abstract":"ARBs, angiotensin receptor blockers; ACEIs, angiotensin-converting enzyme inhibitors; COVID-19, coronavirus disease 2019; SARS, severe acute respiratory syndrome. The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as an immediate and global problem just within a few months after its first description in Wuhan-China. Beyond its alarming mortality rate and easily transmissible nature through air droplets, it has also resulted in significant challenges in the cardiovascular area not only due to its higher mortality rates in cardiovascular disease and certain associated conditions, including diabetes mellitus and hypertension, but also due to the theoretically facilitated inoculation of lung tissue by the culprit agent, SARS-CoV-2 in these conditions [1,2]. This worrisome concern has been largely attributed to the potential upregulation of angiotensin enzyme 2 (ACE2) in hypertensive and diabetic patients, and more interestingly; in those receiving angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) [3].","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":" ","pages":"1-2"},"PeriodicalIF":2.3,"publicationDate":"2020-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7540198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25402947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between left ventricular mass index and serum sirtuin 3 level in patients with hypertension.","authors":"Orhan Karayiğit,&nbsp;Muhammet Cihat Çelik,&nbsp;Emrullah Kiziltunç,&nbsp;Hülya Çiçekçioğlu,&nbsp;Canan Topçuoğlu,&nbsp;Birsen Doğanay,&nbsp;Mustafa Çetin","doi":"10.1097/XCE.0000000000000231","DOIUrl":"https://doi.org/10.1097/XCE.0000000000000231","url":null,"abstract":"<p><strong>Objectives: </strong>Sirtuin 3 (SIRT3) can protect cardiomyocytes from oxidative stress-mediated cell damage and prevent cardiac hypertrophy development. The aim of this study was to evaluate whether a relationship existed between left ventricular mass index (LVMI) and serum SIRT3 levels in patients with hypertension.</p><p><strong>Patients and methods: </strong>This study was conducted as a cross-sectional study of 83 patients between April 2018 and October 2018. The LVMI of all patients was calculated using the formula of the American Echocardiography Association and patients were divided into two groups according to results (increased LVMI and normal LVMI).</p><p><strong>Results: </strong>Increased LVMI was determined in 37.3% of patients, whereas 62.7% had normal LVMI. There was no significant difference between serum SIRT3 levels between those with increased LVMI and normal LVMI (5.8 versus 5.4 ng/ml; <i>P</i> = 0.914). Serum pro-brain natriuretic peptide levels (69 versus 41 ng/ml; <i>P</i> = 0.019) were found to be higher in patients with increased LVMI than in those with normal LVMI. A positive correlation between SIRT3 levels and Sm (myocardial systolic) velocity was also determined (<i>r</i> = 0.338; <i>P</i> = 0.002).</p><p><strong>Conclusion: </strong>The serum levels of SIRT3, a molecule which has been proposed to have protective properties against myocardial hypertrophy, were not found to be correlated with LVMI values; however, SIRT3 levels were found to be correlated with Sm velocity, which is accepted to be an indicator of myocardial early diastolic dysfunction.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 2","pages":"99-105"},"PeriodicalIF":2.3,"publicationDate":"2020-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186516/pdf/xce-10-099.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39100976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive evaluation of cardiovascular efficacy and safety outcomes of SGLT2 inhibitors in high risk patients of cardiovascular disease: systematic review and meta-analysis.","authors":"Mukul Bhattarai, Mohsin Salih, Manjari Regmi, Mohammad Al-Akchar, Cameron Koester, Abdisamad Ibrahim, Priyanka Parajuli, Odalys Lara Garcia, Bishal Bhandari, Anis Rehman, Momin Siddique","doi":"10.1097/XCE.0000000000000229","DOIUrl":"10.1097/XCE.0000000000000229","url":null,"abstract":"<p><strong>Objectives: </strong>To demonstrate a magnitude of the cardiovascular benefits, concomitantly analyzing the safety outcomes of sodium-glucose cotransporter 2 inhibitor (SGLT2-I) comprehensively, as a class effect in a larger sample size combined from recent randomized control trials.</p><p><strong>Methods: </strong>We searched electronic databases using specific terms and evaluated 6 efficacy and 10 safety outcomes. Odds ratios (ORs) and 95% confidence interval (CI) were used to compare two interventions.</p><p><strong>Results: </strong>Five studies (<i>n</i> = 41 267) were included, among which 23 539 received SGLT2-I. The SGLT2-I group favored reduction in major adverse cardiovascular events (OR, 0.78; 95% CI, 0.62-0.98; <i>P</i> = 0.03), cardiovascular death (CVD) or heart failure hospitalization (OR, 0.60; 95% CI, 0.46-0.80; <i>P</i> = 0.0004), rate of hospitalization for heart failure (OR, 0.56; 95% CI, 0.44-0.72; <i>P</i> < 0.00001), CVD (OR, 0.68; 95% CI, 0.50-0.93; <i>P</i> = 0.01), all-cause mortality (OR, 0.67; 95% CI, 0.48-0.93; <i>P</i> = 0.02) and myocardial infarction (OR, 0.79; 95% CI, 0.64-0.99; <i>P</i> = 0.04) when compared to the placebo group. Safety analysis showed higher diabetic ketoacidosis (DKA) rate in SGLT2-I group (OR, 2.33; 95% CI, 1.40-3.90; <i>P</i> = 0.001); in contrast, major hypoglycemic events were significantly lower (OR, 0.79; 95% CI, 0.73-0.87; <i>P</i> < 0.00001). AKI was significantly higher in the placebo group (OR, 0.76; 95% CI, 0.65-0.88; <i>P</i> = 0.0004). There were no statistically significant effects on other outcomes.</p><p><strong>Conclusion: </strong>In selected high-risk patients of cardiovascular disease, the SGLT2-I is a potential effective class of drugs for improving cardiovascular outcomes and all-cause mortality without an increased risk of all other major complications except DKA on this meta-analysis.</p>","PeriodicalId":43231,"journal":{"name":"Cardiovascular Endocrinology & Metabolism","volume":"10 2","pages":"89-98"},"PeriodicalIF":2.3,"publicationDate":"2020-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186520/pdf/xce-10-089.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39100975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}