Comparative cardiovascular effectiveness of glucagon-like peptide-1 receptor agonists and sodium–glucose cotransporter-2 inhibitors in atherosclerotic cardiovascular disease phenotypes: a systematic review and meta-analysis
Authors' conclusion
GLP-1 RAs and SGLT2is exhibit distinct cardiovascular effectiveness profiles across ASCVD phenotypes. GLP-1 RAs show particular benefits in peripheral artery disease and post-acute cardiovascular events, while SGLT2is demonstrate unique advantages in ASCVD with comorbid chronic kidney disease. Both are effective in heart failure. These findings support tailored treatment strategies for diverse ASCVD participants based on specific comorbidities and risk factors.
Study context
- Population
- Patients with atherosclerotic cardiovascular disease (ASCVD) across diverse phenotypespatients in twenty-six trials
- Participants
- 151,789 patients
- Comparison
- GLP-1 RAs or SGLT2is against placebo or standard care in ASCVD patients
- Outcome
- MACE:
- Cardiovascular mortality
- Non-fatal myocardial infarction
- Non-fatal stroke
Methodological detailsrandom-effects model
- Random-effects model
Pooled result
As reported in the abstract
Each group vs placebo or standard careRelative risk (95% CI)
GLP-1 RAs
0.85(0.80–0.91)
SGLT2is
0.85(0.80–0.91)
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| MACE in peripheral artery diseaseGLP-1 RAs vs placebo or standard care | 0.86 (0.76–0.98) | |
| MACE in post-acute cardiovascular eventsGLP-1 RAs vs placebo or standard care | 0.90 (0.83–0.97) | |
| MACE in ASCVD with heart failureGLP-1 RAs vs placebo or standard care | 0.73 (0.63–0.84) | |
| MACE in ASCVD with heart failureSGLT2is vs placebo or standard care | 0.86 (0.78–0.95) | |
| MACE in ASCVD with chronic kidney diseaseSGLT2is vs placebo or standard care | 0.84 (0.72–0.99) | |
| MACE in ASCVD with chronic kidney diseaseSGLT2is vs placebo or standard care · severe albuminuria | 0.61 (0.37–0.99) | |
| 0.20.5125Relative risk (log scale) |
Original publication
Comparative cardiovascular effectiveness of glucagon-like peptide-1 receptor agonists and sodium–glucose cotransporter-2 inhibitors in atherosclerotic cardiovascular disease phenotypes: a systematic review and meta-analysis. Eur Heart J Cardiovasc Pharmacother. Published 10 February 2025. doi:10.
Summarised from the published abstract; every number is checked against it