Currently, most international guidelines advocate for risk stratification of acute pulmonary embolism (PE) as a framework to guide treatment decisions. Key prognostic factors for patients with PE include clinical presentation, comorbidities, (imaging) biomarkers and haemodynamic status. The most widely used risk stratification algorithm, outlined in the 2019 European Society of Cardiology/European Respiratory Society guidelines, classifies patients with PE into high-risk (massive), (high or low) intermediate-risk (submassive) and low-risk (nonmassive) categories. It is well established that the risk of adverse outcomes, including mortality, increases with each escalating risk level. However, substantial variation remains among leading international guidelines regarding risk stratification and corresponding treatment recommendations. This inconsistency stems from a lack of grade/level 1A evidence (i.e. strong recommendation based on high-quality evidence) to guide treatment decisions fo

The obesity epidemic has significantly heightened the impact of cardiometabolic risk factors on the global burden of cardiovascular and kidney diseases. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is), originally developed for type 2 diabetes treatment, have demonstrated in randomised controlled trials their ability to reduce the risk of cardiovascular and kidney diseases. This has led to substantial improvements in patient outcomes. SGLT2i, in particular, are the first class of drugs proven to improve the prognosis of patients with heart failure with preserved ejection fraction, and evidence is accumulating to suggest that also GLP-1RA might be beneficial in these patients. Remarkably, the benefits of GLP-1RA and SGLT2i are independent of type 2 diabetes status or baseline renal function. The critical role of these drug classes in managing high cardiovascular risk patients is increasingly acknowledged in guidelines, which no