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In the review, Santos-Ferreira et al. [[1]] discuss different aspects of the association between two frequent comorbidities, type 2 diabetes (T2D) and heart failure (HF). The first trial of patients with prevalent HF found that the risk of worsening HF or death from CV causes was lower in those who received dapagliflozin compared to placebo, regardless of the presence of T2D. [Extracted from the article]

Introduction. We investigated the association of diabetic retinopathy and neuropathy with increased risk of recurrent cardiovascular (CV) events in 6068 patients with type 2 diabetes mellitus (T2DM) and recent acute coronary syndrome (ACS) enrolled in the Evaluation of Lixisenatide in Acute Coronary Syndrome (ELIXA). Methods. History of retinopathy and neuropathy as well as duration of T2DM were self-reported at screening. Proportional hazards regression models were used to assess relationships between retinopathy, neuropathy, and recurrent CV events. Results. At screening, retinopathy and neuropathy were reported in 10.7% and 17.5% of patients, respectively, while 5.7% reported both. When adjusted for randomized treatment only, both retinopathy and neuropathy were associated with a primary composite outcome (CV death, nonfatal MI, stroke, or hospitalization for unstable angina) (retinopathy: HR 1.44, 95% CI 1.19–1.75; neuropathy: HR 1.33, 95% CI 1.12–1.57), CV composite (CV death, nonfatal MI, stroke, hospitalization for heart failure (HF)) (retinopathy: HR 1.57, 95% CI 1.31–1.88; neuropathy: HR 1.38, 95% CI 1.19–1.62), myocardial infarction (retinopathy: HR 1.38, 95% CI 1.08–1.76; neuropathy: HR 1.26, 95% CI 1.02–1.54), HF hospitalization (retinopathy: HR 2.03, 95% CI 1.48–2.78; neuropathy: HR 1.71, 95% CI 1.30–2.27), and all-cause mortality (retinopathy: HR 1.65, 95% CI 1.28–2.12; neuropathy: HR 1.43, 95% CI 1.14–1.78). When included in the same model, and adjusted for T2DM duration, there were no independent associations of either with CV outcomes, while T2DM duration remained strongly associated with all outcomes. Addition of demographic characteristics and CV risk factors did not further alter these relationships. Conclusions. In patients with T2DM and recent ACS, a history of retinopathy and/or neuropathy and longer T2DM duration could be considered clinical markers for high risk of recurrent CV events. This trial is registered with the ELIXA (Evaluation of Lixisenatide in Acute Coronary Syndrome), ClinicalTrials.gov registration number NCT01147250. [ABSTRACT FROM AUTHOR]

Background: Galectin-3 is a protein widely distributed in the heart, brain and blood vessels, and has a regulatory role in inflammation, immunology and cancer. Many studies demonstrated that the increased level of galectin-3 is associated with progressive fibrosis and stiffening of the myocardium. The aim of this study was to investigate the role of galectin-3 in patients with type 2 diabetes (T2D) and/or arterial hypertension (HT). Methods: Study population included 189 patients, with no coronary artery disease, divided into three groups: group 1 (T2D), group 2 (T2D+HT), and group 3 (HT). All subjects underwent routine laboratory tests, as well as specific biomarkers assessment [galectin-3, glycosylated hemoglobin (HbA1c), N- terminal fragment B-type natriuretic peptide (NT-proBNP)]. Cardiological evaluation included physical examination, transthoracic tissue Doppler echocardiography and stress echocardiography. Results: The results of this study demonstrated significantly increased levels of galectin-3, blood glucose, and HbA1c in group 2. Also, echocardiographicaly, left ventricular (LV) diameters and IVS thickness were increased in this group of patients. Furthermore, in the same cohort a positive correlation between galectin-3 and NT-pro BNP, and galectin-3 and LV mass were demonstrated. In addition, a negative correlation between galectin-3 and LV end-diastolic diameter was revealed. Conclusions: This study revealed that levels of galectin-3 were higher in patients with both T2D and HT, and correlated with LV mass, indicating the potential role of this biomarker for early detection of myocardial structural and functional alterations. [ABSTRACT FROM AUTHOR]

Abstract: Objective: In vitro, stimulation of monocytes with antiphospholipid (aPL) antibodies resulted in increased secretion of TNF-alpha, but association of aPL with features of diabetes mellitus is not clarified yet. Therefore, we investigated the distribution of anticardiolipin (aCL), anti-β2gpI (aβ2gpI), anti-annexin A5 (aannxA5), and anti-oxLDL (aoxLDL) antibodies, and TNF-alpha in well-formed group of 78 patients with type II diabetes mellitus without vascular complications. Methods: Investigated antibodies and TNF-alpha concentrations were measured by ELISA. Results: Antiphospholipid antibodies were in positive correlation with TNF-alpha concentrations: aCL IgG (r =0.303, p =0.007), aCL IgM (r =0.386, p =0.000), aβ2gpI IgG (r =0.499, p =0.000), aβ2gpI IgM (r =0.462, p =0.000), aanxA5 IgG (r =0.479, p =0.000), aanxA5 IgM (r =0.641, p =0.000), aoxLDL (IgG+IgM, r =0.279, p =0.000). Anticardiolipin-positive and aCL-negative subgroups differed in TNF-alpha concentrations (Mann–Whitney, p =0.032). Significantly elevated LDL concentrations were noticed in aCL-positive patients with disease duration 10–15years (χ 2 =15.000, p =0.000) and apoB concentrations were elevated in aoxLDL-positive patients with disease duration 7–10years (χ 2 =3.938, p =0.047). Conclusion: Significant association of antiphospholipid antibodies and TNF-alpha might be a marker of severe atherogenic profile (suggested by increased levels of lipids in aPL-positive subgroups) and should be used for the stratification of patients with an increased risk for future deterioration of the disease. [Copyright &y& Elsevier]