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Author Spotlight: A Pharmacodissection Approach to Uncover Mechanisms in Cardiovascular Disease Risk Populations
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Diabetes without Manifest Cardiovascular Disease: A Novel Approach in Risk Stratification and Treatment Selection

Emile Andari1, Samir Arnaout2, Sami T Azar3

  • 1Division of Endocrinology, Department of Internal Medicine, Notre Dame Des Secours, Beirut, Lebanon.

Current Diabetes Reviews
|January 29, 2020
PubMed

Insights

For type 2 diabetes patients, a new consensus recommends risk stratification for cardiovascular disease (CVD). High-risk individuals should receive cardio-protective medications like SGLT2 inhibitors and GLP1 agonists.

Area of Science:

  • Cardiology
  • Endocrinology
  • Diabetes Management

Background:

  • Cardiovascular disease (CVD) is a major complication of type 2 diabetes (T2D), significantly increasing mortality risk.
  • Many T2D patients are asymptomatic for CVD, making screening controversial due to limited data.

Purpose of the Study:

  • To establish a novel expert consensus for approaching T2D patients at high CVD risk.
  • To provide a clear algorithm for CVD risk stratification in T2D.

Main Methods:

  • A stepwise algorithm was developed for risk stratification using the ASCVD calculator.
  • Coronary artery calcium (CAC) scoring further stratifies intermediate-risk T2D patients.

Main Results:

  • Patients are stratified into low, intermediate, and high CVD risk categories.
  • Intermediate-risk patients are reclassified into new low and high-risk groups based on CAC scores.

Conclusions:

  • Low-risk T2D patients should receive standard diabetes care.
  • High-risk T2D patients benefit from SGLT2 inhibitors and GLP1 agonists alongside standard care for cardio-protection.
Abstract

Keywords:
Diabetes mellitusGLP1 agonistsSGLT2 inhibitorscardiovascular diseasemacrovascular complicationsrisk stratification

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