Updates and Top Trials at ACC.25, with Viet Le, DMSc, PA-C

Several major cardiovascular trials presented at the American College of Cardiology (ACC) 2025 Annual Scientific Sessions highlighted the expanding role of glucagon-like peptide 1 (GLP-1) receptor agonists and sodium glucose cotransporter 2 (SGLT2) inhibitors in cardiovascular and metabolic health.

This year’s meeting in Chicago featured more than 4,750 accepted abstracts, with 1,300 expert faculty and 300 sessions, encompassing 53 late-breaking clinical trials.

In an interview at ACC.25, Viet Le, DMSc, PA-C, an associate professor of research and a preventive cardiology PA at Intermountain Health, talks about key updates he felt were most pertinent for practicing clinicians to be aware of from the first 2 days of the meeting

Le highlighted the STRIDE trial examining the effects of semaglutide (1 mg injectable) in patients with peripheral artery disease (PAD) but without diabetes. The investigative team, led by Marc Bonaca, MD, CPC Clinical Research, identified significant cardiovascular benefits for this population, reinforcing findings from the SELECT trial. Based on these results, Le suggested that GLP-1 RAs should be considered cardiovascular drugs, rather than solely for weight management or glucose control. Le indicated the benefits observed in STRIDE were not driven by weight loss, raising further questions about the underlying mechanisms of metabolic dysfunction.

The SOUL trial investigated oral semaglutide and confirmed cardiovascular benefits similar to its injectable counterpart. Le noted that before this trial, there was uncertainty regarding whether the oral formulation would provide the same protective effects. Oral semaglutide was linked to a 14% reduction in major adverse cardiovascular events (MACE) at an average follow-up of four years in high-risk type 2 diabetes (T2D). Le indicated these findings provide reassurance that patients who prefer oral semaglutide due to needle aversion can still achieve cardiovascular benefits.

In the transcatheter aortic valve replacement (TAVR) space, the DapaTAVI trial, conducted across 39 centers in Spain with approximately 1,200 patients, assessed the use of dapagliflozin (10 mg) versus placebo in patients with heart failure aged ≥75 years undergoing TAVR. Le noted the results showed a significant reduction in mortality and improved quality-of-life outcomes, suggesting that SGLT2 inhibitors provide meaningful benefits even in older, frail patients.

Watch the video above to gain more insights from our conversation with Le.

Relevant disclosures for Le include Novartis, Pfizer, Amgen, and Janssen.

References

1. Campbell P. STRIDE: Semaglutide improves functional outcomes in peripheral artery disease. HCP Live. March 29, 2025. Accessed April 2, 2025. https://www.hcplive.com/view/semaglutide-improves-functional-outcomes-in-peripheral-artery-disease.

2. Iapoce C. Soul: Oral Semaglutide Cuts Mace by 14% in people with type 2 diabetes. HCP Live. March 29, 2025. Accessed April 2, 2025. https://www.hcplive.com/view/soul-oral-semaglutide-cuts-mace-by-14-in-people-with-type-2-diabetes.

3. Iapoce C. Dapagliflozin improves outcomes in heart failure after Tavi Procedure. HCP Live. March 30, 2025. Accessed April 2, 2025. https://www.hcplive.com/view/dapagliflozin-improves-outcomes-in-heart-failure-after-tavi-procedure.