ACC Empowers Cardiologists to Use Diabetes Drugs for Heart Disease

COMMENTARY

ACC Pathway Empowers Cardiologists to Use Diabetes Drugs for Heart Disease

Anne L. Peters, MD

Disclosures

July 24, 2019

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This transcript has been edited for clarity.

Today I'm going to discuss the American College of Cardiology (ACC) Expert Consensus Decision Pathway[1] on novel therapies—the SGLT2 inhibitors and GLP-1 receptor agonists—for cardiovascular risk reduction in patients with type 2 diabetes and atherosclerotic cardiovascular disease. I joke that this is about cardiologists who finally want to be endocrinologists. In fact, I think they were jealous of us all along.

Cardiologists are concerned because cardiovascular disease is the leading cause of death in patients with diabetes. Indeed, 65% of deaths in patients with diabetes are due to cardiovascular disease. They have higher risks for coronary heart disease, heart failure, and stroke. Even though our diabetes drugs have not primarily been shown to reduce cardiovascular disease risk until recently, we have been able to show that lowering glucose levels reduces risk for microvascular complications such as nephropathy, neuropathy, and retinopathy.

As I help patients achieve their glycemic targets, I never forget that I'm also reducing the risk for some of these complications that have a terrible impact on a patient's quality of life. As endocrinologists, we need to think about glucose, but now both cardiologists and endocrinologists can think about reducing cardiovascular disease risk in patients with known atherosclerotic cardiovascular disease and diabetes.

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