Mesa 3: Efectos cardiovasculares de fármacos antidiabéticos

Autores/as

  • Pablo Javier Avila Sociedad Argentina de Diabetes (SAD), Obra Social de Empleados Públicos, San Rafael, Mendoza, Argentina
  • Silvana Alejandra Milrad Sociedad Argentina de Diabetes (SAD), Hospital de Rehabilitación Manuel Rocca, Gobierno de la Ciudad de Buenos Aires (GCBA), Ciudad Autónoma de Buenos Aires, Argentina
  • Mariano Forlino Sociedad Argentina de Diabetes (SAD), Centro Médico IMED, San Luis, Argentina
  • Sofía Fabregues Sociedad Argentina de Diabetes (SAD), Centro de Acción y Salud Comunitaria, Nivel 1, Balvanera (CeSAC N° 11), Ciudad Autónoma de Buenos Aires, Argentina
  • Fabiana Vázquez Sociedad Argentina de Diabetes (SAD), Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
  • Cristina Grosso Sociedad Argentina de Diabetes (SAD), Hospital Municipal de Vicente López, Provincia de Buenos Aires, Argentina
  • Ana Schindler Sociedad Argentina de Diabetes (SAD), Centro de Acción y Salud Comunitaria Nivel 1 (CeSAC) N° 15, Ciudad Autónoma de Buenos Aires, Argentina
  • Fabio Zambon Sociedad Argentina de Diabetes (SAD), Ciudad Autónoma de Buenos Aires, Argentina
  • María Virginia Rodríguez Sociedad Argentina de Diabetes (SAD), Ciudad Autónoma de Buenos Aires, Argentina
  • Natalia Carolina Garrido Santos Sociedad Argentina de Diabetes (SAD), Autonomous City of Buenos Aires, Argentina
  • María Laura Calvo Sociedad Argentina de Diabetes (SAD), Hospital Independencia, Santiago del Estero, Argentina
  • Alejandra Maldini Sociedad Argentina de Diabetes (SAD), Centro de Salud Santa Rosa, Universidad Nacional de La Pampa, La Pampa, Argentina
  • Sandra Maserati Sociedad Argentina de Diabetes (SAD), Centro de Diabetes Pilar, Municipio de Pilar, Provincia de Buenos Aires, Argentina
  • Romina Stagno Sociedad Argentina de Diabetes (SAD), Hospital Municipal de Colón y Hospital Municipal de Chacabuco, Provincia de Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v54i2Sup.253

Palabras clave:

agentes antidiabéticos, diabetes mellitus, eventos cardiovasculares, estudios de seguridad cardiovascular, antidiabéticos orales, insulina

Resumen

Los eventos cardiovasculares representan la mayor complicación de la diabetes. La evidencia sugiere que la metformina mejora los resultados cardiovasculares en pacientes con diabetes, especialmente en el United Kingdom Prospective Diabetes Study (UKPDS)  y otros estudios posteriores, por distintos mecanismos.

Hay pocos estudios de seguridad cardiovascular para sulfonilureas aunque no tendrían un perfil seguro a este nivel. La gliclazida parece ser la de mejor performance de las drogas de este grupo. Algo similar ocurre con las meglitinidas, para las cuales los datos indican que no aumentarían el riesgo pero tampoco mejorarían la incidencia de eventos cardiovasculares.

Las tiazolidinodionas son las drogas más cuestionadas, aunque los estudios y metaanálisis son contradictorios no habría dudas que aumentan el riesgo de insuficiencia cardíaca. Los inhibidores de la DPPIV mostraron resultados neutros a excepción de saxagliptina que aumentaría el riesgo de internación por insuficiencia cardiaca.

Existen datos convincentes que los inhibidores de los receptores SGLT-2  a nivel renal y los análogos del GLP-1 intestinal tienen efectos positivos a nivel cardiovascular, con algunas diferencias entre los integrantes de esta familia.

En cuanto a las insulinas, los estudios sugieren que tanto los análogos lentos como rápidos tendrían un mejor perfil cardiovascular, ligado principalmente a la menor incidencia de hipoglucemias severas, que insulina NPH y regular respectivamente.

Biografía del autor/a

Pablo Javier Avila, Sociedad Argentina de Diabetes (SAD), Obra Social de Empleados Públicos, San Rafael, Mendoza, Argentina

Coordinador del Comité de Graduados, Sociedad Argentina de Diabetes (SAD); Médico de la Obra Social de Empleados Públicos

Silvana Alejandra Milrad, Sociedad Argentina de Diabetes (SAD), Hospital de Rehabilitación Manuel Rocca, Gobierno de la Ciudad de Buenos Aires (GCBA), Ciudad Autónoma de Buenos Aires, Argentina

Secretaria del Comité de Hipertensión y otros Factores de Riesgo Cardiovascular, Sociedad Argentina de Diabetes (SAD); Jefa a cargo del Área de Urgencias y Diabetología, Hospital de Rehabilitación Manuel Rocca

Mariano Forlino, Sociedad Argentina de Diabetes (SAD), Centro Médico IMED, San Luis, Argentina

Miembro del Comité de Graduados, Sociedad Argentina de Diabetes (SAD); Director Médico del Centro Médico IMED

Sofía Fabregues, Sociedad Argentina de Diabetes (SAD), Centro de Acción y Salud Comunitaria, Nivel 1, Balvanera (CeSAC N° 11), Ciudad Autónoma de Buenos Aires, Argentina

Miembro del Comité de Graduados de la Sociedad Argentina de Diabetes (SAD); Médica de Planta, Centro de Salud y Acción Comunitario

Fabiana Vázquez, Sociedad Argentina de Diabetes (SAD), Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina

Miembro del Comité de Hipertensión Arterial y otros Factores de Riesgo Cardiovascular, Sociedad Argentina de Diabetes (SAD); Médica de Planta del Servicio de Endocrinología, Metabolismo, Nutrición y Diabetes

Cristina Grosso, Sociedad Argentina de Diabetes (SAD), Hospital Municipal de Vicente López, Provincia de Buenos Aires, Argentina

Miembro del Comité de Hipertensión Arterial y otros Factores de Riesgo Cardiovascular, Sociedad Argentina de Diabetes (SAD); Médica de Planta, Servicio de Clínica Médica, Hospital Municipal de Vicente López

Ana Schindler, Sociedad Argentina de Diabetes (SAD), Centro de Acción y Salud Comunitaria Nivel 1 (CeSAC) N° 15, Ciudad Autónoma de Buenos Aires, Argentina

Miembro del Comité de Graduados, Sociedad Argentina de Diabetes (SAD); Médica de Planta, Centro de Salud y Acción Comunitario

Fabio Zambon, Sociedad Argentina de Diabetes (SAD), Ciudad Autónoma de Buenos Aires, Argentina

Miembro del Comité de Hipertensión Arterial y otros Factores de Riesgo Cardiovascular, Sociedad Argentina de Diabetes (SAD); Gerente de Economía de la Salud, Laboratorio Novo Nordisk

María Virginia Rodríguez, Sociedad Argentina de Diabetes (SAD), Ciudad Autónoma de Buenos Aires, Argentina

Miembro del Comité de Graduados, Sociedad Argentina de Diabetes (SAD); Asesora Médica, Laboratorio Novo Nordisk

Natalia Carolina Garrido Santos, Sociedad Argentina de Diabetes (SAD), Autonomous City of Buenos Aires, Argentina

Miembro del Comité de Graduados, Sociedad Argentina de Diabetes (SAD), Medical Scientific Liason, Laboratorio Novo Nordisk

María Laura Calvo, Sociedad Argentina de Diabetes (SAD), Hospital Independencia, Santiago del Estero, Argentina

Miembro del Comité de Graduados, Sociedad Argentina de Diabetes (SAD); Médica de Planta, Clínica Médica, Hospital Independencia

Alejandra Maldini, Sociedad Argentina de Diabetes (SAD), Centro de Salud Santa Rosa, Universidad Nacional de La Pampa, La Pampa, Argentina

Miembro del Comité de Graduados, Sociedad Argentina de Diabetes (SAD); Médica Diabetóloga, Centro de Salud Santa Rosa

Sandra Maserati, Sociedad Argentina de Diabetes (SAD), Centro de Diabetes Pilar, Municipio de Pilar, Provincia de Buenos Aires, Argentina

Miembro del Comité de Hipertensión Arterial y otros Factores de Riesgo Cardiovascular, Sociedad Argentina de Diabetes (SAD); Médica Diabetóloga de Planta, Centro de Diabetes de Pilar

Romina Stagno, Sociedad Argentina de Diabetes (SAD), Hospital Municipal de Colón y Hospital Municipal de Chacabuco, Provincia de Buenos Aires, Argentina

Miembro del Comité de Graduados, Sociedad Argentina de Diabetes (SAD); Médica de Planta, Servicio Clínica Médica, Hospital Municipal de Colón y Hospital Municipal de Chacabuco

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10-01-2023

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Avila, P. J., Milrad, S. A., Forlino, M., Fabregues, S., Vázquez, F., Grosso, C., Schindler, A., Zambon, F., Rodríguez, M. V., Garrido Santos, N. C., Calvo, M. L., Maldini, A., Maserati, S., & Stagno, R. (2023). Mesa 3: Efectos cardiovasculares de fármacos antidiabéticos. Revista De La Sociedad Argentina De Diabetes, 54(2Sup), 107–122. https://doi.org/10.47196/diab.v54i2Sup.253

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