A Gap That Directly Challenges Cardiology

Q: What is the clinical evidence from this study?

Study design: Letter. Population: Type 2 diabetes and very high-risk cardiorenal disease. Intervention: Newer cardiorenal combination therapies (SGLT2 inhibitors + GLP-1 receptor agonists or finerenone + SGLT2 inhibitors) vs. Renin-angiotensin-aldosterone system inhibitors (RAASi) and classic therapies. Primary outcome: Therapeutic omission gap in guideline-recommended cardiorenal therapies.

Analía L. Guazzone

doi:10.7775/rac.es.v94.i5.21050

October 29, 2026Revista Argentina de CardiologíaOpen Access

A Gap That Directly Challenges Cardiology

View Full Paper

Ask AI

Bookmark

Share

Key Points

Address the critical therapeutic gap in the clinical management of very high-risk cardiorenal disease and explore strategies for implementing evidence-based therapies.
Correspondence and expert commentary discussing implementation challenges and therapeutic inertia in cardiorenal medicine.
Review of published observational evidence and recommendations for establishing dedicated cardiorenal clinical units.
Identifies persistent disparities between guideline-directed medical therapy and real-world prescription patterns in very high-risk cardiorenal cohorts.
Emphasizes that multidisciplinary cardiorenal units are essential to overcome clinical inertia and improve access to evidence-based interventions.

Structured PICO

P

Population

Argentine cohort of very high-risk patients with type 2 diabetes and cardiorenal disease evaluated for implementation gaps in evidence-based cardiorenal therapies.

E

Exposure

Evidence-based cardiorenal therapies including SGLT2 inhibitors, GLP-1 receptor agonists, finerenone, RAAS inhibitors, statins, and antiplatelet therapy

O

Outcome

Proportional therapeutic gap index (brecha terapéutica)

Main Result

Absolute Event Rate: 90% vs 10%

Limitations

Observational design of the underlying study prevents establishing causality
Lack of detailed data on contraindications, tolerability, adherence, insurance coverage, and medication costs
Exploratory associations with older age and female sex lost statistical significance in beta regression
Proportional therapeutic gap index requires external validation and evaluation of sensitivity to change
Observational design prevents establishing causality
Unmeasured variables such as coverage, costs, tolerance, contraindications, and adherence

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Highlights a >90% therapeutic gap in the prescription of newer cardiorenal combination therapies (SGLT2i, GLP-1 RA, finerenone) in very high-risk patients with type 2 diabetes and cardiorenal disease, calling for active cardiologist leadership.

Abstract

No abstract yet. The journal hasn't published one we can show.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Analía L. Guazzone (2026) conducted a letter in Type 2 diabetes and very high-risk cardiorenal disease. Newer cardiorenal combination therapies (SGLT2 inhibitors + GLP-1 receptor agonists or finerenone + SGLT2 inhibitors) vs. Renin-angiotensin-aldosterone system inhibitors (RAASi) and classic therapies was evaluated on Therapeutic omission gap in guideline-recommended cardiorenal therapies.

synapsesocial.com/papers/6aeb26267efe0c3bfbad2891 https://doi.org/10.7775/rac.es.v94.i5.21050

View Full Paper

Ask AI

Bookmark

Share

A Gap That Directly Challenges Cardiology

Key Points

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

A Gap That Directly Challenges Cardiology

Key Points

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading