Differential cardiovascular and renal benefits of SGLT2 inhibitors and GLP1 receptor agonists in patients with type 2 diabetes mellitus. (1st October 2022)

• Record Type: Journal Article
• Authors: Kim, Chee Hae; Hwang, In-Chang; Choi, Hong-Mi; Ahn, Chang Ho; Yoon, Yeonyee E.; Cho, Goo-Yeong
• Is Part Of: International journal of cardiology. Volume 364(2022)
• Page Start: 104
• Page End: 111
• Publication Date: 2022-10-01
• Subjects: Diabetes mellitus -- SGLT2 inhibitors -- GLP1 receptor agonists -- Heart failure -- Renal outcomes; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2022.06.027
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: The differential benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1RA) in cardiovascular or renal outcomes have not been fully investigated. Methods: Patients with diabetes prescribed SGLT2i or GLP1RA were retrospectively identified. Patients treated with antihyperglycemic medications other than SGLT2i or GLP1RA were used as a control group. Primary outcomes were composite ischemic events (acute coronary syndrome, coronary revascularization, and stroke) and a composite of heart failure and renal events (hospitalization for heart failure, renal death, initiation of renal replacement therapy, and renal admission). Results: During a median 38.7 months of follow-up, the incidence of composite ischemic events tended to be lower in the GLP1RA group (annualized rate 0.82% per person-year) than in the other groups (1.68% per person-year in the SGLT2i group and 1.36% per person-year in the control group). The risk of a composite of heart failure and renal outcomes was significantly lower in the SGLT2i group than in the GLP1RA and control groups (0.86% per person-year, 2.33% per person-year, and 1.48% per person-year, respectively). The SGLT2i group had a slower decline in renal function over time compared to that in other groups. Conclusions: SGLT2i showed more benefits in heart failure and renal outcomes, whereas GLP1RA tended to have more favorable ischemic outcomes. Highlights: Recent guidelines recommend SGLT2i and GLP1RA for diabetic patients at higher risk. Direct comparison of SGLT2i and GLP1RA for clinical outcomes are not yet available. We compared the differential benefits of SGLT2i and GLP1RA on CV and renal outcomes. SGLT2i showed more benefits in HF and renal outcomes across various subgroups. GLP1RA tended to have more favorable ischemic outcomes (coronary events and stroke).