Why the study?
Most patients with T2D do not have obvious CVD symptoms, and CVD screening in asymptomatic patients with T2D remains highly controversial due to a paucity of data.
How should patients with type 2 diabetes without manifest cardiovascular disease be risk-stratified and treated to prevent cardiovascular events?
How should patients with type 2 diabetes without manifest cardiovascular disease be risk-stratified and treated to prevent cardiovascular events?
This consensus statement provides a stepwise algorithm for CVD risk stratification in asymptomatic T2D patients, recommending SGLT2 inhibitors and GLP1 agonists for those identified as high risk.
Expert consensus frames CVD risk assessment in asymptomatic T2D; leaves open need for prospective outcome trials before routine adoption.
BACKGROUND: Cardiovascular disease (CVD), the main macro vascular complication of type 2 diabetes (T2D), increases the risk of death significantly in patients with T2D. INTRODUCTION: Most of the patients with T2D do not have obvious CVD symptoms. Due to the paucity of data, CVD screening in asymptomatic patients with T2D remains highly controversial. METHODS: This has driven a panel of experts to establish a novel consensus on how to approach patients with T2D at high CVD risk. The panel formulated a stepwise algorithm by which patients with T2D undergo initial risk stratification into low, intermediate and high risk using the ASCVD calculator. In patients with intermediate risk, coronary artery calcium measurement is used to further stratify those patients into new low and high-risk categories. RESULTS AND CONCLUSION: The panel recommends using standard diabetes care in low risk patients and using SGLT2 inhibitors and GLP1 agonists with cardio protective effect, on top of standard care, in high risk individuals.
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Andari et al. (2020) conducted a review in Type 2 Diabetes without manifest Cardiovascular Disease. Stepwise risk stratification algorithm using ASCVD calculator and coronary artery calcium measurement vs. Standard diabetes care was evaluated. An expert panel recommends a stepwise risk stratification algorithm using the ASCVD calculator and coronary artery calcium measurement to guide SGLT2 inhibitor and GLP1 agonist use in T2D patients.
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