Cardiovascular drugs that have shaped the decade

Abstract:

The first study to introduce NOAC (non-vitamin-K oral anticoagulants) to broad clinical practice was the RE-LY study with dabigatran. The robust design with proven SPAF doses confirmed the efficacy and safety in several specific patient groups (during PVI, after PCI), also reflected by the real-life data. The concept of anticoagulation with dabigatran has been rounded up by currently still the only practically and pragmatically available antidote. The historical focus of diabetes type 2 treatment on glucose control was never able to conclusively prove its positive effect on hard cardiovascular endpoints and/or macrovascular complications. Therefore, with the new data on cardiovascular death reduction and heart failure endpoints, this “glucocentric” approach had to give way to a “holistic” perspective based on cardiovascular risk control. Special responsibility rests with the cardiologists, who should actively look for patients with appropriate characteristics, who are suitable for the relatively simple and safe, as well as – in the right indication – highly effective treatment with sodium-glucose cotransporter 2 inhibitors, SGLT2i, aiming at reduction of cardiovascular endpoints and death. The most recent data will most probably contribute to further emancipation of SGLT2i beyond diabetes, with expected changes of the heart failure guidelines, introducing the new, fifth treatment group with effect on mortality in these patients.

Key words:
heart failure; NOAC; oral anticoagulants; SGLT2 inhibitors