Expert Conversations: How to Choose and Initiate a Novel Agent for Patients With CVD and Diabetes

While researchers originally explored sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide (GLP)-1 receptor agonists for their impact on blood glucose, the two classes of agents were unexpectedly found to have cardiovascular benefits. In this podcast, Ralph Brindis, MD, MPH, interviews Laurence Sperling, MD, about implementing SGLT2 inhibitors and GLP-1 receptor agonists into the treatment of patients with cardiovascular disease and diabetes.

Additional Resources

• Zinman B, Wanner C, Lachin JM, et al. EMPA-REG OUTCOME Investigators. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373:2117-2128. doi:10.1056/NEJMoa1504720
• Das SR, Everett BM, Birtcher KK, et al. 2018 ACC expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes and atherosclerotic cardiovascular disease: a report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol. 2018;72(24). doi:10.1016/j.jacc.2018.09.020
• Vaduganathan M, Sathiyakumar V, Singh A, et al. Prescriber patterns of SGLT2i after expansions of U.S. Food and Drug Administration labeling. J Am Coll Cardiol. 2018;72(25):3370-3372. doi:10.1016/j.jacc.2018.08.2202
• McMurray JJV, Solomon SD, Inzucchi SE, et al; DAPA-HF trial committees and investigators. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med. 2019;381:1995-2008. doi:10.1056/NEJMoa1911303
• American College of Cardiology. CardioSmart. Accessed April 15, 2020. https://www.cardiosmart.org/
• American College of Cardiology. Key considerations in use of GLP-1RAs and SGLT2is for CV risk reduction in patients with ASCVD and T2D. Updated May 2019. Accessed April 16, 2020. https://www.acc.org/~/media/3637039CEAAD474A95E6A1F3DFC850B3.pdf

Ralph G. Brindis, MD, MPH, is a clinical professor of medicine with the Department of Medicine & the Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco. He is also the senior medical officer, External Affairs, for the American College of Cardiology (ACC) National Cardiovascular Data Registry. From 2010 to 2011, he served as the president of the ACC.

Laurence Sperling, MD, is a Katz professor in preventive cardiology and a professor of global health at the Rollins School of Public Health at Emory University in Atlanta, Georgia. He is also the executive director of the Million Hearts for the Centers for Disease Control and Prevention/Centers for Medicare and Medicaid Services.