Type 2 diabetes mellitus (T2DM) portends high risk of atherosclerotic cardiovascular (CV) events and of CV mortality; moreover, this group of patients has a very high probability of developing heart failure (HF). In this review, we discuss new advances in pharmacological treatment both in CV prevention and in HF management with a special focus on T2DM patients. A large number of randomized clinical trials and meta-analyses provided strong evidence about therapeutic strategies acting on glucose metabolism, such as GLP-1 RA and SGLT2i and about lipid-lowering treatment, such as PCSK9i and icosapent ethyl. Moreover, SGLT2i demonstrated strong evidence of benefit particularly in HF management both in diabetic and non-diabetic patients. The pathophysiological bases of multiple mechanisms of benefit of this class of drug explain the unexpected and remarkable results demonstrated both by prevention trials and by trials dedicated only to HF (like DAPA-HF). These, new drugs in the CV therapeutic armamentarium are establishing a new comprehensive approach from prevention to therapy of HF, giving more emphasis on HF classification in four stages (A→D). New therapies, which are on the horizon, promise to further reduce CV mortality and morbidity in HF patients irrespective of diabetic status.

中文翻译：

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心脏病学与糖尿病学之间的相互作用：优化心血管预防和心脏衰竭管理的新合作。

2型糖尿病（T2DM）预示着动脉粥样硬化性心血管（CV）事件和CV死亡率的高风险；此外，该组患者极有可能发生心力衰竭（HF）。在这篇综述中，我们讨论了药物预防和心血管治疗方面的新​​进展，特别是针对T2DM患者。大量的随机临床试验和荟萃分析为有关影响糖代谢的治疗策略（如GLP-1 RA和SGLT2i）以及降脂治疗（如PCSK9i和二十碳五烯酸乙酯）提供了有力的证据。此外，SGLT2i表现出有力的证据，特别是在糖尿病和非糖尿病患者的HF治疗中获益。此类药物受益的多种机制的病理生理学基础解释了预防性试验和仅针对HF的试验（如DAPA-HF）所显示的出乎意料的显着结果。CV治疗性武器库中的这些新药正在建立从预防到治疗HF的新的综合方法，更加强调了四个阶段（A→D）的HF分类。即将出现的新疗法有望进一步降低HF患者的CV死亡率和发病率，而与糖尿病状态无关。