Glucagon-like peptide-1 receptor agonists improve outcomes in individuals with type 2 diabetes with and without heart failure
Related Experiment Video
Updated: Jun 10, 2025
Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model
Published on: November 29, 2024
Yu Horiuchi1, Nicholas Wettersten2, Masahiko Asami1
1Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
Background:
The effectiveness of glucagon-like peptide-1 receptor agonists (GLP1Ras) for prevention of heart failure (HF) in patients with type 2 diabetes (T2DM) without HF and for risk of death in patients with T2DM with HF has not been fully elucidated in routine clinical practice.
Methods:
Using the real-world global electronic medical record TriNetX database, individuals with T2DM and with or without HF who initiated either GLP1Ras or sitagliptin from 2017 to 2020 were retrospectively analyzed. In individuals with T2DM without HF, the primary outcome was a composite of all-cause mortality and a new diagnosis of HF within three years. In individuals with T2DM with HF, the primary outcome was all-cause mortality within three years. Propensity-score (PS) matching was used to adjust for over 100 baseline characteristics.
Results:
A total of 65,598 individuals with T2DM without HF starting a GLP1Ras were PS matched with 65,598 starting sitagliptin. GLP1Ras were associated with a lower incidence of the composite endpoint (10.5 % versus 11.8 %, hazard ratio [HR] 0.82, [0.80-0.85], p < 0.001), mortality (HR 0.66 [0.63-0.69]) and new diagnosis of HF (HR 0.92 [0.88-0.96]). There were 6002 individuals in each group matched for T2DM and HF. Mortality was lower in the GLP1Ras group (17.6 % versus 22.8 %, HR 0.70 [0.65-0.76], p < 0.001). Results were consistent across subgroups.
Conclusions:
In this global real-world data analysis, GLP1Ra use was associated with a lower risk of death and HF in individuals with T2DM without HF, and lower risk of death in those with HF.
Insights
Glucagon-like peptide-1 receptor agonists (GLP1Ras) reduce heart failure (HF) risk and death in type 2 diabetes (T2DM) patients. Real-world data shows GLP1Ras improve outcomes for T2DM patients with or without HF.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Effectiveness of GLP1Ras for HF prevention in T2DM without HF is unclear.
- GLP1Ras' role in reducing mortality for T2DM with HF needs more study.
Purpose of the Study:
- To evaluate GLP1Ras effectiveness in preventing HF and reducing mortality in T2DM patients.
- To compare GLP1Ras with sitagliptin in real-world clinical practice.
Main Methods:
- Retrospective analysis of TriNetX database (2017-2020).
- Included T2DM patients with or without HF initiating GLP1Ras or sitagliptin.
- Propensity-score matching used to control for over 100 baseline characteristics.
Main Results:
- GLP1Ras associated with lower composite endpoint of mortality and new HF diagnosis in T2DM without HF (HR 0.82).
- GLP1Ras significantly reduced all-cause mortality (HR 0.66) and new HF diagnosis (HR 0.92) in T2DM without HF.
- In T2DM with HF, GLP1Ras showed lower mortality (HR 0.70) compared to sitagliptin.
Conclusions:
- GLP1Ra use is linked to reduced risk of death and HF in T2DM patients without HF.
- GLP1Ras are associated with a lower risk of death in T2DM patients with HF.
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