Heart failure & cardiomyopathiesCohort study
Risk of Heart Failure Hospitalization for GLP-1 Receptor Agonists Versus DPP-4 Inhibitors or SGLT-2 Inhibitors in Patients With Type 2 Diabetes: A Target Trial Emulation
- Target trial emulation (observational cohort study)
- 2 emulated target trials
- population-based
- inverse probability of treatment weighting
- intention-to-treat
Authors' conclusion
GLP-1RA use is associated with a lower risk of HHF compared with DPP-4i and similar risks compared with SGLT-2i in routine clinical care for patients with type 2 diabetes.
Study context
- Population
- Adults with T2DM, population-based health care data, Stockholm, Sweden, 2010–2021trial 1 n = 32,979
- Exposure
- GLP-1RA vs DPP-4i and vs SGLT-2i
- Outcome
- Hospitalization for heart failure (HHF)
Main finding
As reported in the abstract
Hospitalization for HF · 3 years
Weighted hazard ratio (95% CI)
GLP-1RA vs DPP-4itrial 1
0.77(0.66–0.91)
GLP-1RA vs SGLT-2itrial 2
1.02(0.85–1.18)
Observational data: associations, not effects.
Further findings
| Outcome | weighted HR (95% CI) | |
|---|---|---|
| MACE (positive control outcome) | 0.85 (0.74–0.99) | |
| 0.512Weighted hazard ratio (log scale) |
Single agents, per-protocol analyses, subgroups
- Results consistent for single agents, in per-protocol analyses, and in the majority of subgroups
- Absolute risk difference largest in patients with higher predicted baseline HF risk
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Risk of Heart Failure Hospitalization for GLP-1 Receptor Agonists Versus DPP-4 Inhibitors or SGLT-2 Inhibitors in Patients With Type 2 Diabetes: A Target Trial Emulation. Circulation. Published 24 February 2026. doi:10.1161/circulationaha.125.075157
Summarised from the published abstract; every number is checked against it