9
7. SGLT2 inhibitors decrease MACE among patients with T2DM,
with some evidence supporting metformin may also reduce
MACE. While they do not have an indication as anti-obesity
agents, metformin and SGLT2 inhibitors modestly reduce body
weight in patients with and without T2DM; when accompanied
by weight loss, other anti-obesity drugs reduce CVD risk factors
(i.e., orlistat, liraglutide, naltrexone/bupropion, and phentermine/
topiramate are not contraindicated in patients with CVD).
Retrospective data suggests phentermine and topiramate may
not increase the risk of MACE.
8. Among patients with obesity, CVD and T2DM without congestive
cardiomyopathy, initial drug treatments to consider include
metformin, liraglutide, semaglutide, and SGLT2 inhibitors.
9. Among patients with obesity, CVD, T2DM with mild congestive
cardiomyopathy, initial drug treatments to consider in include
metformin and SGLT2 inhibitors.
10. Among patients with obesity, CVD, and without T2DM and
without congestive cardiomyopathy, initial treatments to
consider include liraglutide 0.6 mg subcutaneously titrated to 3.0
mg per day.
