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Decrease of coronary heart disease risk with GLP1-receptor agonists or SGLT2 inhibitors therapy in patients with type

Luca D'Onofrio1, Carmen Mignogna1, Angela Carlone1

  • 1Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy.

Diabetes Research and Clinical Practice
|January 31, 2021
PubMed
Abstract

Insights

Glucagon-like peptide-1 receptor-agonists (GLP1 RAs) and sodium-glucose co-transporter 2 inhibitors (SGLT2is) significantly reduce coronary heart disease (CHD) risk in type 2 diabetes patients. Both therapies showed risk reduction within 6 months, with SGLT2is demonstrating a greater effect initially.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes (T2D) is a major risk factor for cardiovascular disease.
  • Primary cardiovascular prevention in T2D patients requires effective risk-reduction strategies.
  • Glucagon-like peptide-1 receptor-agonists (GLP1 RAs) and sodium-glucose co-transporter 2 inhibitors (SGLT2is) are increasingly used in T2D management.

Purpose of the Study:

  • To evaluate the real-world effectiveness of GLP1 RAs and SGLT2is in reducing coronary heart disease (CHD) risk.
  • To assess the impact of these therapies on 10-year CHD risk in T2D patients undergoing primary cardiovascular prevention.
  • To compare the efficacy of GLP1 RAs versus SGLT2is in mitigating CHD risk over time.

Main Methods:

  • Retrospective analysis of data from 312 T2D patients without prior CHD history.
  • Patients were categorized into GLP1 RA (n=174) and SGLT2i (n=138) treatment groups.
  • The UKPDS-RE score was used to estimate 10-year CHD risk at baseline and at 6, 12, and 24 months post-treatment initiation.

Main Results:

  • Both GLP1 RA and SGLT2i therapies significantly decreased 10-year CHD risk over 24 months (p=0.037 and p<0.001, respectively).
  • Significant CHD risk reduction was observed within the first 6 months for both groups (3% with GLP1 RA, 7% with SGLT2i; p<0.001).
  • SGLT2i showed a greater risk reduction than GLP1 RA at 6 and 12 months, but this difference was not significant at 24 months. Significant reductions were noted in severe risk categories for both treatments.

Conclusions:

  • GLP1 RAs and SGLT2is are effective in reducing 10-year cardiovascular disease risk in T2D patients.
  • These findings support the use of GLP1 RAs and SGLT2is for primary cardiovascular prevention in T2D.
  • The study highlights the rapid onset of cardiovascular risk reduction with these agents in a real-world setting.
Keywords:
Cardiovascular riskGLP1 RASGLT2iType 2 diabetes

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