Call to action: Understanding the differences in the use of SGLT-2 inhibitors and GLP-1 receptor agonists.
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2023-03
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Cardiovascular disease remains one of the most prominent global health problems and has been demonstrated to disproportionally affect certain communities. Despite an increasing collective effort to improve health inequalities, a multitude of disparities continue to affect cardiovascular outcomes. Among the most prominent disparities within cardiovascular disease prevention are with the use and distribution of sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists. Several landmark trials have demonstrated the efficacy of these novel agents, not only in cardiovascular disease prevention among those with diabetes, but also in heart failure and chronic kidney disease. However, the use of these agents remains limited by disparities in certain racial/ethnic, sex, and socioeconomic groups. This review works to highlight and understand these differences on the use and prescribing patterns of pivotal agents in cardiovascular disease prevention, SGLT-2 inhibitors and GLP-1 agonists. Our aim is to enrich understanding and to inspire efforts to end disparities in cardiovascular morbidity and mortality due to race, sex and income inequality.
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Khedagi, Apurva, Cara Hoke, Michelle Kelsey, Andrea Coviello, W Schuyler Jones, Larry R Jackson, Manesh R Patel, Rob W McGarrah, et al. (2023). Call to action: Understanding the differences in the use of SGLT-2 inhibitors and GLP-1 receptor agonists. American journal of preventive cardiology, 13. p. 100477. 10.1016/j.ajpc.2023.100477 Retrieved from https://hdl.handle.net/10161/26997.
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William Schuyler Jones
I am an interventional cardiologist with a specific focus on the diagnosis and treatment of patients with cardiovascular disease. As a clinician, I see patients in the office and do coronary and peripheral vascular procedures (angiography and interventions) in the Duke Cardiac Catheterization Laboratory. I have served as the Medical Director of the cath lab at Duke since 2016. Alongside my partners in the cath lab, we collaborate with our cardiothoracic surgeons to hold Heart Team meetings each week, and we frequently are asked to address complex cardiovascular issues as a multidisciplinary team.
I also have a broad background in cardiovascular site-based research, multicenter clinical trials, clinical event classification, and observational analyses. I have helped to lead clinical trial efforts at the Duke Clinical Research Institute (DCRI) by designing and conducting studies evaluating new and existing treatments for patients with coronary artery disease and peripheral artery disease. My specific research interests include examining access to care and disparities in care for patients with peripheral artery disease and the design and conduct of pragmatic clinical trials in cardiovascular disease.
Larry Ronald Jackson
Dr. Jackson is a physician-scientist with clinical expertise in adult clinical cardiac electrophysiology. His research focuses on identifying determinants of racial/ethnic differences in arrhythmia care and the development and implementation of patient-centered interventions aimed at facilitating shared decision-making in populations that have been systemically disadvantaged with abnormal heart rhythm conditions. Dr. Jackson has an advanced degree (MHSc) in clinical and qualitative research methodology and is a member of the Duke Clinical Research Institute. His research skills, obtained during his time at the Duke Clinical Research Institute Research Fellowship, include formal training in large database analysis, clinical trial operations, scientific writing, clinical trial adjudication and statistical analysis. Dr. Jackson’s research funding consists of two career development awards: 1) National Institute of Health/National Heart, Lung, and Blood Institute-K01 focused on racial and ethnic differences in oral anticoagulation use in patients with atrial fibrillation and 2) AHA career development award focused on analyzing racial and ethnic differences in the use of rhythm control strategies in patients with atrial fibrillation. Dr. Jackson’s long-term, overarching goal as a physician-scientist is to decrease racial and ethnic disparities in arrhythmia care for patients with abnormal heart rhythm conditions.
Manesh Raman Patel
Manesh Patel is the Chief of the Division of Cardiology and the Division of Clinical Pharmacology. His clinical interests include diagnostic and interventional coronary angiography, peripheral angiography and endovascular intervention. His is involved in several clinical trials involving patients with cardiovascular disease and in cardiac imaging. He is also the Chair of the American College of Cardiology Task Force for Appropriate Use Criteria for Cardiovascular Procedures and is Chair of the American Heart Association Diagnostic and Interventional Cath Committee.
Patel's interest in cardiac imaging, quality of care, cardiac devices is also evident in his research. His integration of these efforts into his roles at Duke was recognized in 2010 when he received the prestigious Duke Cardiology Fellowship Mentor Award. In 2011, Dr. Patel was named the endowed John Bush Simpson Assistant Professor of Cardiology. In 2013, Dr. Patel received the Robert M. Califf Faculty clinical research Award.
Currently, Dr. Patel is leading an effort to redesign the delivery of care to patients undergoing invasive catheterization procedures in the health system with a specific aim of measure and providing individualized, patient centered, innovative, and efficient care.
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