#JustReleased: ACC recommends SGLT2 Inhibitors, GLP-1RAs in
A recently published expert consensus document by the American College of Cardiology (ACC) recommends the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with type 2 diabetes and clinically evident atherosclerotic cardiovascular disease (ASCVD) to lower their CV risk. The guidance document has been published in the Journal of the American College of Cardiology.

As per the recent evidence SGLT2 inhibitors have been associated with a 14% reduced risk for major adverse CV events relative to placebo. GLP-1RAs have been associated with up to a 26% risk reduction, but in some studies there was no significant benefit.

This is the latest Expert Consensus Pathway document, part of ACC's ongoing Clinical Pathway efforts to provide cardiovascular professionals practical guidance, particularly in areas of emerging science where evidence is limited.

The Pathway, which is endorsed by the American Diabetes Association (ADA) three key areas where cardiovascular professionals are uniquely positioned to assist with the management of T2D patients:

1) Screening for T2D in patients with or at high risk of cardiovascular disease
2) Aggressively treating cardiovascular risk factors
3) Incorporating data for newer antihyperglycemic agents into routine practice

"Previously, [cardiovascular] care in patients with diabetes was centered around risk factor optimization, and the medications used for glycemic control were not expected to demonstrate direct [cardiovascular] benefit. The recent development of two novel classes of therapies – SGLT2 inhibitors and GLP-1RAs – has, for the first time, demonstrated that treatments developed for glucose lowering can directly improve [cardiovascular] outcomes." The authors write in the consensus document.

Some of the key points in the document are:-
• The pathway provides practical guidance on when and how to incorporate the use of SGLT2 inhibitors and GLP-1Ras in the treatment of patients with T2D and ASCVD with the express goal of reducing cardiovascular risk and optimizing outcomes.

• Clinicians should provide guideline-directed medical therapy (e.g., lipid-lowering treatment, antiplatelet therapy) and glucose-lowering treatment like metformin. At the same time, they should consider adding an SGLT2 inhibitor (empagliflozin is the preferred agent) or a GLP-1RA (liraglutide is preferred) with proven CV benefit following a discussion with the patient.

• The pathway also strongly encourages patient discussions that review of risks, potential benefits, and different treatment options.

The American College of Cardiology is a 52,000-member medical society that is the professional home for the entire cardiovascular care team. The mission of the College is to transform cardiovascular care and to improve heart health.

Note: This list is a brief compilation of some of the key recommendations included in the Guideline and is not exhaustive and does not constitute medical advice. Kindly refer to the original publication here: https://pxmd.co/dJ82H
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