The use of glucagon-like-peptide-1 receptor agonist in the cardiology practice.
Pieter MartensChantal MathieuThomas VanasschePublished in: Acta cardiologica (2022)
The presence of type 2 diabetes confronts the patient with an elevated risk to develop atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), or chronic kidney disease (CKD). Glucose control in itself does not prevent these complications in their entirety. More recently several agents within the class of Sodium-Glucose cotransporter 2 inhibitors (SGLT2-I) and Glucagon-like-peptide-1 receptor agonists (GLP-1RA) have emerged as preferred agents to tackle the residual risk of ASCVD, HF, and CKD in patients with type 2 diabetes. Despite compelling trial data and professional society endorsement, the uptake of these agents in clinical practice is low. Especially GLP-1RA is only used in 8% of eligible candidates with type 2 diabetes and <5% of these prescriptions are attributed to cardiologists. This low uptake amongst cardiologists is related to the unfamiliarity with this class, its initiation, and titration, hesitation regarding simultaneous adjustment of other glucose-lowering agents, the unaccustomedness to prescribing injectable agents, and differential medical priorities. This review aims to offer cardiologists a practical tool for the optimal use of a GLP-1RA in their suitable patients and is focussed on the Belgian field of practice.
Keyphrases
- chronic kidney disease
- end stage renal disease
- type diabetes
- cardiovascular disease
- heart failure
- primary care
- healthcare
- rheumatoid arthritis
- clinical practice
- disease activity
- ankylosing spondylitis
- clinical trial
- ejection fraction
- acute heart failure
- systemic lupus erythematosus
- blood pressure
- coronary artery disease
- prognostic factors
- left ventricular
- atrial fibrillation
- randomized controlled trial
- study protocol
- skeletal muscle
- acute kidney injury
- phase ii
- case report
- double blind
- adverse drug
- cardiac resynchronization therapy