The year 2021 saw molecules like glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter 2 inhibitors (SGLT-2i), continuing their journey as path-breaking cardiovascular protective agents. The latest trials have been more cardio-renal-focused. A meta-analysis has confirmed relative risk reduction of major adverse cardiovascular events by almost 16% and reduction of ischemic events in type 2 diabetes with GLP-1 receptor agonists. SELECT trial assessing secondary prevention in individuals without diabetes is currently underway.

Results from several new trials on SGLT2 inhibitors have also paved the way for their journey in the treatment landscape. VERTIS trial showed that SGLT2 inhibitors cause consistent benefits on heart failure hospitalization for patients with T2D and ASCVD. EMPEROR-Preserved trial showed efficacy and safety of empagliflozin in patients with HFpEF. SOLOIST and SCORED trials have gathered evidence of sotagliflozin in diabetes and worsening heart failure, ASCVD, and CKD. DAPA-HF and EMPEROR-reduced trial results demonstrated efficacy and safety of dapagliflozin and empagliflozin in patients with HFrEF. 

Reference: Cosentino F, Bhatt DL, Marx N, Verma S. The year in cardiovascular medicine 2021: diabetes and metabolic disorders. European Heart Journal. 2022; ehab876. DOI: 10.1093/eurheartj/ehab876