Cardiovascular benefit of antidiabetic agents: narrative revue of clinical evidence

The 2019 ESC-EASD guidelines on diabetes, pre-diabetes, and cardiovascular diseases recommend the first line prescription of GLP-1 RA and SGLT2i in type 2 diabetes patients at high cardiovascular risk to reduce clinical events incidence. Metformine reduces the incidence of cardiovascular events in obese type 2 diabetes patients and remains a first line prescription recommendation combined with GLP-1 RA or SGLT2i. Randomized clinical trials and meta-analysis demonstrated the beneficial risk to benefit ratio of GLP- 1 RA with significant reduction of total mortality and atherosclerotic events in type 2 diabetes patients at high cardiovascular risk. Randomized clinical trials and meta-analysis demonstrated the beneficial risk to benefit ratio of SGLT2i with a significant reduction of total mortality, reduction of hospitalization for heart failure and increased nephroprotection in type 2 diabetes patients at high cardiovascular risk.