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GLP-1RAs and SGLT2is Reduce Cardiovascular Events Independent of Reductions of Systolic Blood Pressure and Body

Mei Qiu1, Liang-Liang Ding2, Miao Zhang3

  • 1Department of General Medicine, Shenzhen Longhua District Central Hospital, Shenzhen, 518110, China. 13798214835@sina.cn.

Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders
|August 28, 2020
PubMed
Abstract

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) offer similar benefits for major adverse cardiovascular events and all-cause death in type 2 diabetes. SGLT2is better reduce heart failure hospitalizations, while GLP-1RAs reduce stroke risk.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes (T2D) management involves medications like GLP-1RAs and SGLT2is.
  • The comparative impact of these drug classes on cardiovascular events and the role of blood pressure and weight reduction remain unclear.

Purpose of the Study:

  • To compare the efficacy of GLP-1RAs and SGLT2is in reducing cardiovascular events in T2D patients.
  • To investigate the influence of systolic blood pressure and body weight reduction on cardiovascular outcomes.

Main Methods:

  • A meta-analysis of 11 randomized trials was conducted.
  • Hazard ratios (HR) and 95% confidence intervals (CI) were used to assess six cardiovascular endpoints.
  • Meta-regression explored differences between drug classes and the impact of physiological changes.

Main Results:

  • SGLT2is significantly reduced hospitalization for heart failure (HHF) more than GLP-1RAs (32% vs 9%).
  • GLP-1RAs reduced stroke risk (16%), an effect not observed with SGLT2is.
  • Both drug classes similarly reduced major adverse cardiovascular events (MACE), cardiovascular death (CVD), myocardial infarction (MI), and all-cause death (ACD).

Conclusions:

  • GLP-1RAs and SGLT2is provide comparable benefits for MACE, CVD, MI, and ACD in T2D.
  • SGLT2is demonstrate a superior effect on HHF reduction compared to GLP-1RAs.
  • Cardiovascular event reduction by these agents is independent of systolic blood pressure and body weight changes.
Keywords:
Cardiovascular eventsGLP-1RAsSGLT2isType 2 diabetes

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