ECHO Reducing Atherosclerotic Cardiovascular Disease in Patients with Type 2 Diabetes: TeleECHO - Pretest

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According to the American Heart Association (AHA), what is the most important preventative modality for the primary prevention of cardiovascular disease?

Taking daily aspirin

Performing 10-Year ASCVD risk assessments

Promotion of a healthy lifestyle

High-dose statin therapy

A 54-year-old, overweight male with history of type 2 diabetes mellitus (T2DM) and family history of heart disease presents for regular interval diabetic assessment. His blood sugars are under control with metformin monotherapy, his BP is normal, and his most recent LDL is 195. He takes no other medications. What would be the most appropriate intervention(s) for cardiovascular disease prevention in this patient?

Initiation of an SGLT2-inhibitor

Initiation of a GLP-1 receptor agonist

Initiation of statin therapy

Initiation of daily aspirin therapy

Meta-analyses for SGLT2i trials EMPA-REG, CANVAS and DECLARE-TIMI demonstrated which of the following?

Reduced hazard ratios for MACE with SGLT2-inhibitors vs. placebo

Reduced hazard ratios for heart failure hospitalizations with SGLT2-inhibitors vs. placebo

Reduced hazard ratios for the progression of chronic kidney disease with SGLT2-inhibitors vs. placebo

All of the above

A 61-year-old female with a 10-year history of T2DM treated with metformin presents for diabetes management. She has a BMI of 31, history of left ventricular hypertrophy with intact ejection fraction, lower extremity peripheral arterial disease and an A1C of 7.3. She has had trouble losing weight despite following a Mediterranean diet and daily 30-minute walks. Considering the current ADA-EASD guidelines, intervention with which of the following would be least appropriate for this patient?

Dipeptidyl peptidase-4 (DPP-4) inhibitor

GLP-1 receptor agonist

Basal insulin

SGLT2 inhibitor