2022 Canadian Cardiovascular Society Guideline for Use of GLP-1 Receptor Agonists and SGLT2 Inhibitors for Cardiorenal Risk Reduction in Adults.

{"article_title":"2022 Canadian Cardiovascular Society Guideline for Use of GLP-1 Receptor Agonists and SGLT2 Inhibitors for Cardiorenal Risk Reduction in Adults.","author":"\"Mancini, G B John , O'Meara, Eileen , Zieroth, Shelley , Bernier, Mathieu , Cheng, Alice Y Y , Cherney, David Z I , Connelly, Kim A , Ezekowitz, Justin , Goldenberg, Ronald M , Leiter, Lawrence A , Nesrallah, Gihad , Paty, Breay W , Pich\u00e9, Marie-Eve , Senior, Peter , Sharma, Abhinav , Verma, Subodh , Woo, Vincent , Darras, Pol , Gr\u00e9goire, Jean , Lonn, Eva , Stone, James A , Yale, Jean-Fran\u00e7ois , Yeung, Colin , Zimmerman, Deborah\"","journal_title":"The Canadian journal of cardiology","issn":"1916-7075 ; Electronic","isbn":"","publication_date":"20220801","volume":"38","issue":"8","first_page":"1153","page_count":"15","accession_number":"35961754","doi":"10.1016\/j.cjca.2022.04.029","publisher":"Elsevier","doctype":"Journal Article; Practice Guideline; Comment","subjects":"Cardiology ","interest_area":["Endocrinology"," Cardiology"],"abstract":"This guideline synthesizes clinical trial data supporting the role of glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter 2 inhibitors (SGLT2i) for treatment of heart failure (HF), chronic kidney disease, and for optimizing prevention of cardiorenal morbidity and mortality in patients with type 2 diabetes. It is on the basis of a companion systematic review and meta-analysis guided by a focused set of population, intervention, control, and outcomes (PICO) questions that address priority cardiorenal end points. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system and a modified Delphi process were used. We encourage comprehensive assessment of cardiovascular (CV) patients with routine measurement of estimated glomerular filtration rate, urinary albumin-creatinine ratio, glycosylated hemoglobin (A1c), and documentation of left ventricular ejection fraction (LVEF) when evaluating symptoms of HF. For patients with HF, we recommend integration of SGLT2i with other guideline-directed pharmacotherapy for the reduction of hospitalization for HF when LVEF is > 40% and for the reduction of all-cause and CV mortality, hospitalization for HF, and renal protection when LVEF is \u2264 40%. In patients with albuminuric chronic kidney disease, we recommend integration of SGLT2i with other guideline-directed pharmacotherapy to reduce all-cause and CV mortality, nonfatal myocardial infarction, and hospitalization for HF. We provide recommendations and algorithms for the selection of glucagon-like peptide-1 receptor agonists and SGLT2i for patients with type 2 diabetes and either established atherosclerotic CV disease or risk factors for atherosclerotic CV disease to reduce all-cause and CV mortality, nonfatal stroke, and for the prevention of hospitalization for HF and decline in renal function. We offer practical advice for safe use of these diabetes-associated agents with profound cardiorenal benefits.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=35961754&authtype=shib&custid=ns346513"}