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Secondary Prevention of Cardiovascular Events in Patients with Overweight/Obesity in Routine Clinical Practice.

Wenxin Guo, Maidou Wang, Jiwon Shin

    Medrxiv : the Preprint Server for Health Sciences
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    Summary

    Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show potential for cardiovascular event reduction in overweight patients. GLP-1 RAs demonstrated a lower risk of major adverse cardiovascular or cerebrovascular events compared to phentermine-topiramate.

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    Area of Science:

    • Cardiology
    • Endocrinology
    • Pharmacology

    Background:

    • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective for cardiovascular disease secondary prevention in overweight/obese patients without diabetes.
    • Comparative effectiveness of GLP-1 RAs against other anti-obesity medications is not well-established.

    Purpose of the Study:

    • To compare the effectiveness of GLP-1 RAs with other anti-obesity medications for cardiovascular event prevention.

    Main Methods:

    • Retrospective, observational cohort study using electronic health records (Truveta database).
    • Included adults with BMI ≥27 kg/m², history of cardiovascular disease, and no diabetes.
    • Primary endpoint: time to major adverse cardiovascular or cerebrovascular event (MACCE).

    Main Results:

    • GLP-1 RA use was associated with decreased MACCE hazard versus bupropion-naltrexone and phentermine-topiramate in unweighted analysis.
    • In weighted analysis, GLP-1 RA was not associated with lower MACCE hazard than bupropion-naltrexone.
    • GLP-1 RA was associated with lower MACCE hazard than phentermine-topiramate (aHR 0.61; 95% CI 0.41-0.91).

    Conclusions:

    • Prescription of GLP-1 RAs was linked to a reduced risk of subsequent MACCE compared to phentermine-topiramate.
    • GLP-1 RAs may offer a cardiovascular benefit over phentermine-topiramate in this patient population.