Primary Occurrence of Cardiovascular Events After Adding Sodium–Glucose Cotransporter-2 Inhibitors or Glucagon-like Peptide-1 Receptor Agonists Compared With Dipeptidyl Peptidase-4 Inhibitors: A Cohort Study in Veterans With Diabetes
Authors' conclusion
The addition of GLP1RA was associated with primary reductions of MACE and HF hospitalization compared with DPP4i use; SGLT2i addition was not associated with primary MACE prevention.
Study context
- Population
- US veterans aged ≥18 years with diabetes adding GLP1RA, SGLT2i or DPP4i to metformin, sulfonylurea or insulin, 2001–2019; primary CV preventionweighted pairs
- Exposure
- GLP1RA or SGLT2i vs DPP4i added to metformin, sulfonylurea or insulin
- GLP1RAn = 28,759
- SGLT2in = 21,200
- Outcome
- Major adverse cardiac events (MACE) (acute MI, stroke or CV death) and heart failure (HF) hospitalization
Methodological detailsweighted cohort, pairwise comparisons
- Weighted cohort
- Pairwise comparisons
Main finding
As reported in the abstract
MACE and HF
Each group vs DPP4iAdjusted hazard ratio (95% CI)
GLP1RA28 759 vs 28 628 weighted pairs
0.82(0.72–0.94)
SGLT2i21 200 vs 21 170 weighted pairs
0.91(0.78–1.08)
Each group vs DPP4iaRD, events per 1000 person-years (95% CI)
GLP1RA
3.2(1.1–5.0)
Each group vs DPP4iaRD (95% CI)
SGLT2i
1.28(−1.12 to 3.32)
Observational data: associations, not effects.
Original publication
Primary Occurrence of Cardiovascular Events After Adding Sodium–Glucose Cotransporter-2 Inhibitors or Glucagon-like Peptide-1 Receptor Agonists Compared With Dipeptidyl Peptidase-4 Inhibitors: A Cohort Study in Veterans With Diabetes. Ann Intern Med. Published 9 May 2023. doi:10.
Summarised from the published abstract; every number is checked against it