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Inicio Medicina Clínica (English Edition) Antidiabetic drugs for stroke prevention in patients with type-2 diabetes. The n...
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Vol. 150. Issue 7.
Pages 275-281 (April 2018)
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Vol. 150. Issue 7.
Pages 275-281 (April 2018)
Review
DOI: 10.1016/j.medcle.2018.01.017
Antidiabetic drugs for stroke prevention in patients with type-2 diabetes. The neurologist's point of view
Antidiabéticos en prevención de ictus en pacientes con diabetes tipo 2. El punto de vista del neurólogo
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Blanca Fuentes
Servicio de Neurología y Centro de Ictus, Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain
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Table 1. Summary of the characteristics of the main antidiabetic drugs showing reduction of global vascular risk.
Abstract

To date, stroke prevention in patients with diabetes mellitus (DM) has been based on the control of other risk factors and comorbidities, as clinical trials aimed at intensive glycemic control have failed to prove the existence of any sort of benefit in reducing macrovascular complications. However, thanks to the FDA's requirement to evaluate the vascular risk of antidiabetic drugs, there has been significant progress in the knowledge of their benefits on the risk of vascular death, acute myocardial infarction and non-fatal stroke in patients with type 2 DM and high vascular risk. This implies the need to incorporate these drugs into the overall vascular prevention strategy in patients with DM who have already suffered a stroke. This manuscript is a critical, non-systematic review on the oral antidiabetics that have demonstrated any sort of effect on stroke risk, interpreting the results of the main clinical trials from the neurologist's point of view.

Keywords:
Stroke
Diabetes mellitus
Antidiabetic agents
Prevention
Resumen

Hasta el momento, la prevención de ictus en pacientes con diabetes mellitus (DM) se basaba en el control de otros factores de riesgo y comorbilidades, ya que los ensayos clínicos de control glucémico intensivo no habían demostrado eficacia en la reducción de complicaciones macrovasculares. Pero gracias al requerimiento de la FDA de evaluar el riesgo vascular de los fármacos antidiabéticos, se ha producido un importante avance en el conocimiento de sus beneficios sobre el riesgo de muerte vascular, infarto agudo de miocardio e ictus no fatales en los pacientes con DM tipo 2 y alto riesgo vascular. Esto supone la necesidad de incorporar estos fármacos en la estrategia de prevención vascular global en pacientes con DM que ya han tenido un ictus. Se presenta una revisión crítica, no sistemática, de los fármacos antidiabéticos que han mostrado algún efecto sobre el riesgo de ictus, interpretando sus resultados desde la perspectiva del neurólogo.

Palabras clave:
Ictus
Diabetes mellitus
Fármacos antidiabéticos
Prevención

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