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The use of glucagon-like-peptide-1 receptor agonist in the cardiology practice

Pieter Martens1,2, Chantal Mathieu3, Thomas Vanassche2

  • 1Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.

Acta Cardiologica
|May 16, 2022
PubMed

Insights

Glucagon-like-peptide-1 receptor agonists (GLP-1RA) show promise in reducing cardiovascular and kidney risks for type 2 diabetes patients. This review provides cardiologists with practical guidance to improve GLP-1RA adoption in clinical practice.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes significantly increases the risk of atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), and chronic kidney disease (CKD).
  • While glucose control is essential, it does not fully mitigate these residual risks.
  • Sodium-Glucose cotransporter 2 inhibitors (SGLT2-I) and Glucagon-like-peptide-1 receptor agonists (GLP-1RA) are emerging as key agents for managing these complications.

Approach:

  • This review focuses on providing cardiologists with a practical framework for prescribing GLP-1RA.
  • It addresses common barriers to adoption, including unfamiliarity with the drug class, initiation and titration protocols, and managing concomitant glucose-lowering therapies.
  • The guidance is tailored to the Belgian clinical practice setting.

Key Points:

  • Despite strong evidence and guidelines, the uptake of GLP-1RA in type 2 diabetes patients remains low, particularly among cardiologists.
  • Cardiologists' hesitation stems from unfamiliarity, concerns about prescribing injectable medications, and managing complex medication adjustments.
  • Optimal use of GLP-1RA can significantly reduce residual ASCVD, HF, and CKD risks in eligible patients.

Conclusions:

  • Improving cardiologists' understanding and confidence in prescribing GLP-1RA is crucial for enhancing patient outcomes.
  • Practical, evidence-based guidance can overcome barriers to adoption and improve the management of cardiorenal risk in type 2 diabetes.
  • This review serves as a valuable resource for Belgian cardiologists to effectively integrate GLP-1RA into their practice.

Keywords:
DiabetesGLP1-receptor agonistatherosclerotic cardiovascular diseaseheart failurequality of careweight loss

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