Use of optimal medical therapy in patients with diabetes and atherosclerotic cardiovascular disease: Insights from a prospective longitudinal cohort study

Only 11% of patients with atherosclerotic cardiovascular disease and diabetes received comprehensive optimal medical therapy by the end of a 2-year follow-up.

• At follow-up, 58% of patients were on high-intensity lipid-lowering therapy, 87% on antithrombotics, 71% on ACE inhibitors/ARBs/ARNIs, and 17% on SGLT2 inhibitors/GLP-1 receptor agonists.
• The proportion of patients receiving comprehensive optimal medical therapy improved from 8% at baseline to 11% by the end of follow-up.
• Patients treated by cardiologists were more likely to be on high-intensity lipid-lowering therapy but less likely to use SGLT2 inhibitors or GLP-1 receptor agonists compared to those treated by non-cardiologists.
• Older age was associated with lower odds of receiving optimal medical therapy, while private insurance and coronary disease were associated with higher odds.
• There was moderate variability in the use of optimal medical therapy, independent of patient factors.

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