Reduciendo eventos cardiovasculares en pacientes con DM2: nuevas evidencias 23/06/16 18:00h Casa del Corazón, Madrid http://ecvdm2.secardiologia.es #ECVDM2 Impacto de estos resultados en los pacientes diabéticos en Prevención Secundaria Dr. Domingo Marzal Martín, Complejo Hospitalario de Mérida (Badajoz) @domingomarzal

1. Madrid, junio 2016
Domingo Marzal Martín
Impacto en los pacientes diabéticos en
prevención secundaria
Reduciendo eventos cardiovasculares en pacientes con DM2: nuevas evidencias

2. Ray KK, et al. Lancet 2009;373:1765-72
All-Cause Mortality
Intensive vs standard glucose lowering

6. Metformin in patients with diabetes and HF
Eurich D, et al. Circ Heart Fail 2013;6:395-402
Metformin reduced mortality: HR 0.80 (0.74-0.87); p<0.001
All-cause mortality

7. 2013 2014 2015 2016
SAVOR-TIMI 53
HR 1.00 (IC 95% 0.89-1.12)
N Engl J Med. 2013;369:1317-26
EXAMINE
HR 0.96 (IC 95% LS ≤1.16)
N Engl J Med. 2013;369:1327-35
TECOS
HR 0.98 (IC 95% 0.89-1.08)
N Engl J Med. 2015;373:232-42
ELIXA
HR 1.02 (IC 95% 0.89-1.17)
N Engl J Med. 2015;373:2247-57
INCRETINAS

8. Pfeffer MA, et al. N Engl J Med. 2015;373:2247-57

9. Zinman B, et al. N Engl J Med. 2015; 26;373:2117-28
CV death
HR 0.62
(95% CI 0.49, 0.77)
p<0.0001
HR 0.86
(95.02% CI 0.74-0.99)
p=0.0382
primary outcome: 3-point MACE
HR 0.68
(95% CI 0.57, 0.82)
p<0.0001
all-cause mortality
HR 0.65
(95% CI 0.50, 0.85)
p=0.0017
hospitalization for heart failure

10. Piepoli MF, et al. Eur Heart J. 2016
Recommendations for management of diabetes

11. 2013 2014 2015 2016
SAVOR-TIMI 53
HR 1.00 (IC 95% 0.89-1.12)
N Engl J Med. 2013;369:1317-26
EXAMINE
HR 0.96 (IC 95% LS ≤1.16)
N Engl J Med. 2013;369:1327-35
TECOS
HR 0.98 (IC 95% 0.89-1.08)
N Engl J Med. 2015;373:232-42
ELIXA
HR 1.02 (IC 95% 0.89-1.17)
N Engl J Med. 2015;373:2247-57
LEADER
LiraglutideINCRETINAS

12. Marso SP, et al. N Engl J Med. 2016; DOI: 10.1056/NEJMoa1603827
LEADER
baseline characteristics

13. Marso SP, et al. N Engl J Med. 2016; DOI: 10.1056/NEJMoa1603827
LEADER
baseline cardiovascular risk profile

14. Marso SP, et al. N Engl J Med. 2016; DOI: 10.1056/NEJMoa1603827
LEADER
baseline cardiovascular risk profile

15. Marso SP, et al. N Engl J Med. 2016; DOI: 10.1056/NEJMoa1603827
LEADER: HbA1c

16. Marso SP, et al. N Engl J Med. 2016; DOI: 10.1056/NEJMoa1603827
Primary outcome
CV death, non-fatal myocardial infarction, or non-fatal stroke

17. Marso SP, et al. N Engl J Med. 2016; DOI: 10.1056/NEJMoa1603827
CV death
non-fatal MI non-fatal stroke

18. Marso SP, et al. N Engl J Med. 2016; DOI: 10.1056/NEJMoa1603827
Primary outcome: subgroup analyses

19. Marso SP, et al. N Engl J Med. 2016; DOI: 10.1056/NEJMoa1603827
All-cause death

20. Marso SP, et al. N Engl J Med. 2016; DOI: 10.1056/NEJMoa1603827
Hospitalization for heart failure

21. Marso SP, et al. N Engl J Med. 2016; DOI: 10.1056/NEJMoa1603827
Time to first microvascular endpoints

22. safety

26. Piepoli MF, et al. Eur Heart J. 2016
Recommendations for management of diabetes
Liraglutide ...

27. gracias por vuestra atención
domingo.marzal@secardiologia.es
@domingomarzal