Comparative Efficacy of GLP-1 RAs Versus SGLT2 Inhibitors in Patients With Acute Myocardial Infarction Undergoing
Ibrahim Khalil1, Pallab Sarker2, Supoma Ghosh Ria3
1Dhaka Medical College and Hospital, Dhaka, Bangladesh.
Summary
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show better outcomes than sodium-glucose cotransporter-2 inhibitors (SGLT2is) in heart attack patients after PCI. GLP-1 RAs reduced risks of heart failure, hospitalization, and major adverse events long-term.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Research
Background:
- Direct comparisons between GLP-1 RAs and SGLT2is in acute myocardial infarction (AMI) patients post-PCI are lacking.
- Real-world evidence is crucial for understanding comparative effectiveness.
Purpose of the Study:
- To compare short-, mid-, and long-term clinical outcomes of GLP-1 RAs versus SGLT2is in adults with AMI undergoing PCI.
- Utilize a multicenter, propensity score-matched real-world cohort.
Main Methods:
- Retrospective cohort study using TriNetX US Collaborative Network data.
- Propensity score matching (1:1) created balanced cohorts of 1752 patients each (GLP-1 RAs vs. SGLT2is).
- Kaplan-Meier and Cox models analyzed mortality, heart failure, hospitalization, RMI, stroke, AFib, MACE, AKI, and cardiac arrest.
Main Results:
- GLP-1 RAs associated with lower 1-year risks of acute heart failure, hospitalization, RMI, stroke, atrial fibrillation, MACE, and AKI compared to SGLT2is.
- GLP-1 RAs showed lower absolute risk reduction for acute heart failure and hospitalization at 30 days.
- All-cause mortality was lower at 1 year with GLP-1 RAs; no significant difference in cardiac arrest.
Conclusions:
- GLP-1 RA initiation was linked to reduced short- and long-term adverse outcomes compared to SGLT2i in AMI patients post-PCI.
- These observational findings highlight potential benefits of GLP-1 RAs.
- Randomized trials are needed to confirm these real-world findings.
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