{"id":134258,"date":"2024-02-25T21:58:40","date_gmt":"2024-02-26T02:58:40","guid":{"rendered":"https:\/\/ccs.ca\/?post_type=guideline&p=134258"},"modified":"2024-03-26T21:05:45","modified_gmt":"2024-03-27T01:05:45","slug":"chapter-1-abstract","status":"publish","type":"guideline","link":"https:\/\/ccs.ca\/guideline\/cardiorenal-2022\/chapter-1-abstract\/","title":{"rendered":"Abstract"},"content":{"rendered":"\n
This guideline synthesizes clinical trial data supporting the role of glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter 2 inhibitors (SGLT2i) for treatment of heart failure (HF), chronic kidney disease, and for optimizing prevention of cardiorenal morbidity and mortality in patients with type 2 diabetes. It is on the basis of a companion systematic review and meta-analysis guided by a focused set of population, intervention, control, and outcomes (PICO) questions that address priority cardiorenal end points. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system and a modified Delphi process were used. We encourage comprehensive assessment of cardiovascular (CV) patients with routine measurement of estimated glomerular filtration rate, urinary albumin-creatinine ratio, glycosylated hemoglobin (A1c), and documentation of left ventricular ejection fraction (LVEF) when evaluating symptoms of HF. For patients with HF, we recommend integration of SGLT2i with other guideline-directed pharmacotherapy for the reduction of hospitalization for HF when LVEF is > 40% and for the reduction of all-cause and CV mortality, hospitalization for HF, and renal protection when LVEF is \u2264 40%. In patients with albuminuric chronic kidney disease, we recommend integration of SGLT2i with other guideline-directed pharmacotherapy to reduce all-cause and CV mortality, nonfatal myocardial infarction, and hospitalization for HF. We provide recommendations and algorithms for the selection of glucagon-like peptide-1 receptor agonists and SGLT2i for patients with type 2 diabetes and either established atherosclerotic CV disease or risk factors for atherosclerotic CV disease to reduce all-cause and CV mortality, nonfatal stroke, and for the prevention of hospitalization for HF and decline in renal function. We offer practical advice for safe use of these diabetes-associated agents with profound cardiorenal benefits.<\/p>\n","protected":false},"featured_media":0,"parent":134255,"menu_order":1,"template":"guideline-chapter.php","topic":[],"resource_type":[],"acf":[],"yoast_head":"\n