TY - JOUR
T1 - Effectiveness of glucose-lowering medications on cardiovascular outcomes in patients with type 2 diabetes at moderate cardiovascular risk
AU - McCoy, Rozalina G.
AU - Herrin, Jeph
AU - Swarna, Kavya Sindhu
AU - Deng, Yihong
AU - Kent, David M.
AU - Ross, Joseph S.
AU - Umpierrez, Guillermo E.
AU - Galindo, Rodolfo J.
AU - Crown, William H.
AU - Borah, Bijan J.
AU - Montori, Victor M.
AU - Brito, Juan P.
AU - Neumiller, Joshua J.
AU - Mickelson, Mindy M.
AU - Polley, Eric C.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature Limited 2024.
PY - 2024/4
Y1 - 2024/4
N2 - Cardiovascular disease (CVD) is the leading cause of death among people with type 2 diabetes1–5, most of whom are at moderate CVD risk6, yet there is limited evidence on the preferred choice of glucose-lowering medication for CVD risk reduction in this population. Here, we report the results of a retrospective cohort study where data for US adults with type 2 diabetes and moderate risk for CVD are used to compare the risks of experiencing a major adverse cardiovascular event with initiation of glucagon-like peptide-1 receptor agonists (GLP-1RA; n = 44,188), sodium-glucose cotransporter 2 inhibitors (SGLT2i; n = 47,094), dipeptidyl peptidase-4 inhibitors (DPP4i; n = 84,315) and sulfonylureas (n = 210,679). Compared to DPP4i, GLP-1RA (hazard ratio (HR) 0.87; 95% confidence interval (CI) 0.82–0.93) and SGLT2i (HR 0.85; 95% CI 0.81–0.90) were associated with a lower risk of a major adverse cardiovascular event, whereas sulfonylureas were associated with a higher risk (HR 1.19; 95% CI 1.16–1.22). Thus, GLP-1RA and SGLT2i may be the preferred glucose-lowering agents for cardiovascular risk reduction in patients at moderate baseline risk for CVD. ClinicalTrials.gov registration: NCT05214573.
AB - Cardiovascular disease (CVD) is the leading cause of death among people with type 2 diabetes1–5, most of whom are at moderate CVD risk6, yet there is limited evidence on the preferred choice of glucose-lowering medication for CVD risk reduction in this population. Here, we report the results of a retrospective cohort study where data for US adults with type 2 diabetes and moderate risk for CVD are used to compare the risks of experiencing a major adverse cardiovascular event with initiation of glucagon-like peptide-1 receptor agonists (GLP-1RA; n = 44,188), sodium-glucose cotransporter 2 inhibitors (SGLT2i; n = 47,094), dipeptidyl peptidase-4 inhibitors (DPP4i; n = 84,315) and sulfonylureas (n = 210,679). Compared to DPP4i, GLP-1RA (hazard ratio (HR) 0.87; 95% confidence interval (CI) 0.82–0.93) and SGLT2i (HR 0.85; 95% CI 0.81–0.90) were associated with a lower risk of a major adverse cardiovascular event, whereas sulfonylureas were associated with a higher risk (HR 1.19; 95% CI 1.16–1.22). Thus, GLP-1RA and SGLT2i may be the preferred glucose-lowering agents for cardiovascular risk reduction in patients at moderate baseline risk for CVD. ClinicalTrials.gov registration: NCT05214573.
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U2 - 10.1038/s44161-024-00453-9
DO - 10.1038/s44161-024-00453-9
M3 - Letter
AN - SCOPUS:85189355929
SN - 2731-0590
VL - 3
SP - 431
EP - 440
JO - Nature Cardiovascular Research
JF - Nature Cardiovascular Research
IS - 4
ER -