SGLT2 inhibitors and GLP-1 receptor agonists reduce cardiovascular events and heart failure hospitalizations in patients with type 2 diabetes and CIHD; high-intensity lipid lowering achieves LDL-C <1.4 mmol/L associated with reduced events; prolonged DAPT (≥12 months) decreases ischemic events in high-risk CIHD patients beyond one year post-ACS.
Draft global implementation guidelines defining coronary artery disease as any degree of atherosclerotic involvement exceeding zero percent stenosis.
Ischemic heart disease (IHD) remains the leading cause of morbidity and mortality worldwide. Coronary artery disease (CAD) encompasses any pathological process capable of compromising myocardial perfusion and although numerous etiologies exist, including vasculitis, spontaneous coronary artery dissection, and coronary embolism, the majority of CAD is attributable to coronary atherosclerosis, which constitutes the focus of this document. For practical purposes, CAD is considered present when any degree of atherosclerotic involvement exceeds zero percent stenosis, recognizing that even minimal coronary atherosclerosis represents a systemic disease process with prognostic implications.
Writing Task Force iCARDIO-Alliance (Thu,) conducted a other in Patients with chronic ischemic heart disease (CIHD) including those with associated conditions such as type 2 diabetes mellitus, heart failure with reduced or preserved ejection fraction, ischemia with non-obstructive coronary arteries, and refractory angina. Various interventions including pharmacotherapy (SGLT2 inhibitors, GLP-1 receptor agonists, high-intensity statins, PCSK9 inhibitors, aspirin, DAPT, colchicine), lifestyle modification, revascularization (PCI, CABG), and diagnostic assessments (imaging and invasive testing) was evaluated on Cardiovascular events including cardiovascular death, recurrent myocardial infarction, hospitalization for heart failure, stroke, and symptom control. SGLT2 inhibitors and GLP-1 receptor agonists reduce cardiovascular events and heart failure hospitalizations in patients with type 2 diabetes and CIHD; high-intensity lipid lowering achieves LDL-C <1.4 mmol/L associated with reduced events; prolonged DAPT (≥12 months) decreases ischemic events in high-risk CIHD patients beyond one year post-ACS.