For individuals with diabetes without preexisting cardiovascular disease, the addition of glucagon-like peptide 1 receptor agonists (GLP1-RA) is associated with a lower risk for major adverse cardiac events (MACE) and heart failure, according to a study published online May 9 in the Annals of Internal Medicine.
Tadarro L. Richardson Jr., M.D., from the VA Tennessee Valley Healthcare System Geriatric Research Education Clinical Center in Nashville, and colleagues examined whether MACE incidence is lower with the addition of GLP1-RA or sodium-glucose cotransporter 2 inhibitors (SGLT2i) versus dipeptidyl peptidase-4 inhibitors (DPP4i) onto metformin, sulfonylurea, or insulin treatment alone or in combination. A total of 28,759 GLP1-RA versus 28,628 DPP4i weighted pairs and 21,200 SGLT2i versus 21,170 DPP4i weighted pairs were included in the study.
The researchers found lower MACE and heart failure risk in association with GLP1-RA versus DPP4i (adjusted hazard ratio, 0.82; 95 percent confidence interval, 0.72 to 0.94), for an adjusted risk difference of 3.2 events per 1,000 person-years. There was no association observed for SGLT2i versus DPP4i with MACE and heart failure (adjusted hazard ratio, 0.91; 95 percent confidence interval, 0.78 to 1.08).
“These findings are hypothesis generating, and further evaluation of these medications as part of primary [cardiovascular disease] prevention strategy is needed,” the authors write.
