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Interpreting Absolute and Relative Risk Reduction in the Context of Recent Cardiovascular Outcome Trials in Patients

David D Berg1, Ahmed A Kolkailah2,3, Ashish Sarraju4

  • 1TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Suite 7022, Boston, MA, 02115, USA. dberg1@bwh.harvard.edu.

Current Diabetes Reports
|November 6, 2021
PubMed
Abstract

Insights

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) offer cardiovascular benefits for type 2 diabetes mellitus (T2DM) patients. Individualized risk assessment is crucial for applying trial results in clinical practice.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes mellitus (T2DM) management increasingly emphasizes cardiovascular risk reduction.
  • Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) demonstrate significant cardiovascular benefits.

Purpose of the Study:

  • Review cardiovascular outcomes trials (CVOTs) of SGLT2i and GLP-1 RA.
  • Discuss relative versus absolute risk reduction in T2DM.
  • Highlight individualized risk assessment for clinical application.

Main Methods:

  • Review of published cardiovascular outcomes trials for SGLT2i and GLP-1 RA.
  • Analysis of risk reduction concepts (relative vs. absolute).
  • Evaluation of clinical and biomarker-based risk assessment tools.

Main Results:

  • SGLT2i and GLP-1 RA have established cardiovascular benefits in T2DM.
  • Risk prediction for atherosclerotic cardiovascular disease (ASCVD) and heart failure hospitalization (HHF) can be refined using clinical scores and biomarkers.
  • Personalized risk assessment is vital for optimizing treatment decisions.

Conclusions:

  • Clinicians must consider both relative and absolute treatment benefits when initiating SGLT2i and GLP-1 RA.
  • Utilize risk assessment tools to guide patient counseling and treatment selection for cardiovascular risk reduction in T2DM.
Keywords:
Atherosclerotic cardiovascular diseaseCardiovascular riskGlucagon-like peptide 1 receptor agonistHeart failureSodium-glucose cotransporter-2 inhibitorType 2 diabetes mellitus

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