About Dr. Darren K. McGuire, MD, MHSc

Dr. Darren K. McGuire, MD, MHSc is Professor of Medicine at UT Southwestern Medical Center in Dallas, Texas in the Division of Cardiology, where he holds the Dallas Heart Ball Chair for Research on Heart Disease in Women and is a Distinguished Teaching Professor. Dr. McGuire is the Lead Physician of the Parkland Hospital and Health System Cardiology clinics. Dr. McGuire’s expertise is in large scale clinical trial design and execution, and drug registration/regulation, with a focus in the area of diabetes and cardiovascular disease. He presently has leadership roles for numerous international cardiovascular clinical outcomes trials, including T2DM, obesity, and lipid trials. Dr. McGuire is a previous member of the FDA Cardiovascular and Renal Drugs Advisory Committee and remains an FDA ad hoc consultant. He is Deputy Editor of Circulation and Senior Editor of Diabetes and Vascular Disease Research. Dr. McGuire has authored/co-authored over 240 peer-reviewed manuscripts, reviews, editorials and book chapters.

Antihyperglycemic Agents and Heart Failure (HF): An Examination of Recent Studies

In the last 10 years, the study of medications for type 2 diabetes (T2D) has rapidly Antihyperglycemic Agents and Heart Failure (HF): An Examination of Recent Studiesexpanded its investigational footprint to evaluate cardiovascular (CV) effects, a shift driven largely by regulatory guidance that requires at least a demonstration of CV safety. Clinical investigators are also concerned with the effect diabetes medications have on atherosclerotic vascular outcomes as well as HF.

Working with Covance’s Dr. Jonathan Plehn in the webinar The Diabetic Heart: A Focus On Heart Failure, I recently provided a high-level overview of the clinical outcomes data examining the effect of antihyperglycemic therapies on heart failure (HF).

Only a handful of trials1 have analyzed more versus less-intensive glycemic control with regards to the effects on HF. In the ACCORD trial, there was a trend for increased risk with more intense glucose control (OR 1.23, 95% CI 0.97-1.57). In contrast, the UKPDS, ADVANCE and VADT trials suggested a favorable effect, although these results were not clinically relevant nor statistically significant. Meta-analysis of the totality of these data suggests there is essentially no effect, either positive or negative, on HF events with glycometabolic modulation using the older therapies available for T2D. Below, I review specific therapies in more detail. Continue reading