Thanks, @chfpharmd !

SGLT-2 Inhibitors have quickly become one of the most talked-about pharmacotherapeutic classes in medicine. Let’s take a step back and understand how we got to this point and how you can use these agents in practice.
We can thank the -flozins for all of the wonderful data we now have with antihyperglycemic and their role in the prevention and treatment of CV disease. Since 2008, the FDA now requires cardiovascular outcomes trials based on these agents being linked to undesirable CV outcomes.
Cardiovascular disease is a global epidemic. Prevention is key. But we also need therapeutics for preventing recurrent CV disease as well.
Diabetes and CV disease are inextricably linked. DM induces inflammation in coronary arteries, leading to ASCVD. HF can be a direct result of this. DM also enhances LV hypertrophy, playing a role in HFpEF.
There are four large CVOTs that assessed the SGLT2Is in patients with ASCVD and DM. Of note, only Empagliflozin and Canagliflozin demonstrated superiority to placebo for MACE. However, HF hospitalizations were reduced by all four drugs.
These CVOTs set the stage for DAPA-HF and EMPEROR-Reduced. Both trials demonstrated an overall reduction in the composite of CV death and HF hospitalization in HFrEF patients with or without diabetes mellitus.
The 2021 HF guidelines now recommend SGLT2I be considered after ARNi and BB are initiated, in patients with ACC/AHA Stage C HFrEF (NYHA II-IV), without preference for Dapagliflozin or Empagliflozin.
How about patients with ASCVD or CKD? Take a look below and follow this useful algorithm that also incorporates the GLP-1 receptor agonists.. Ultimately, there are MANY patients that can benefit from these therapies!
We have more SGLT2i data on the way as well. Most notably, in the HFpEF space. Stay tuned! 2021 may have some exciting news.
@threadreaderapp "unroll"

• • •

Missing some Tweet in this thread? You can try to force a refresh

Keep Current with ACCP Cardiology PRN

ACCP Cardiology PRN Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!


Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @accpcardprn

12 Apr 20

Dr. Zohour Anouassi is a PGY1 Pharmacy Resident at Cleveland Clinic Abu Dhabi (CCAD) She completed her pharmacy education at the University of Sharjah and then pursued a Masters of Health Economics at Sorbonne University Abu Dhabi. During her residency...
thus far she has worked closely with her Cardiology rotation preceptor Bassam Atallah, PharmD, MS, BCPS-AQ Cardiology, FHFSA. Zohour completed one cardiology rotation and will also have another elective rotation in CHF transitionS of care. She has also worked on several....
cardiology related projects, including a protocol for eptifibatide use, dofetilide education, and has recently contributed to the Cardiology PRN newsletter on the topic of antithrombotic management post TAVR. Her residency research project is in the area of the appropriate....
Read 6 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!