Diabetes and Heart Disease Highlights From ESC 2023

Mikhail N. Kosiborod, MD


September 18, 2023

Dr Mikhail Kosiborod of St Luke's Health System in Kansas City, Missouri, discusses key studies in diabetes and heart disease presented at the European Society of Cardiology (ESC) Congress 2023.

Dr Kosiborod begins with a discussion of the STEP-HFpEF trial, which examined semaglutide in patients with heart failure with preserved ejection fraction and for which he was lead author. He comments that patients on semaglutide achieved the largest improvement ever seen with any pharmacologic intervention of HFpEF, as measured by the Kansas City Cardiomyopathy Questionnaire.

He then reports on revised ESC guidelines in diabetes and cardiovascular disease, including a recommendation for combination therapy with GLP-1 receptor agonists and SGLT2 inhibitors (SGLT2i) in this population.

Next, he turns to the CLEAR Outcomes trial, in which bempedoic acid showed promise in reducing risk for major adverse cardiovascular events (MACE) 4 and MACE 3 in patients with diabetes and those with prediabetes.

Finally, he discusses a study examining the effect of SGLT2i in hospitalized patients with COVID-19. It is notable that 25%-50% of patients in this meta-analysis had diabetes. Although SGLT2i did not offer improved results in all-cause death, the study showed very low rates of adverse events and serious adverse reactions in this acutely ill population. These results underscore the safety of SGLT2i in hospitalized patients, which is highly relevant for management of people with type 2 diabetes and heart failure.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.