Cardiovascular risk and the implications for clinical practice of cardiovascular outcome trials in type 2 diabetes

Prim Care Diabetes. 2020 Jun;14(3):193-212. doi: 10.1016/j.pcd.2019.09.008. Epub 2019 Nov 6.


Cardiovascular disease (CVD) is the primary cause of morbidity and mortality in patients with type 2 diabetes (T2D). This review examines the impact of cardiovascular outcome trials (CVOTs) on clinical practice. To date, all CVOTs have shown non-inferiority versus placebo (both added to standard of care) against a primary endpoint of 3- or 4-point major adverse cardiovascular event (MACE), confirming CV safety of these treatments. Additionally, some CVOTs have shown superiority to placebo against the same MACE endpoint, suggesting a cardioprotective action for these treatments. This is reflected in guideline updates, which primary care physicians should consider when personalizing treatments.

Keywords: Antihyperglycemic; Cardiovascular outcome trials; Cardiovascular risk; Type 2 diabetes.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't