Glucagon-like peptide-1 receptor agonists improve outcomes in individuals with type 2 diabetes with and without heart failure

• Published in: International journal of cardiology 2025-01, Vol.418, p.132611, Article 132611
• Main Authors: Horiuchi, Yu, Wettersten, Nicholas, Asami, Masahiko, Yahagi, Kazuyuki, Komiyama, Kota, Yuzawa, Hitomi, Tanaka, Jun, Aoki, Jiro, Tanabe, Kengo
• Format: Article
• Language: English
• Subjects: Aged; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - mortality; Female; Glucagon-Like Peptide-1 Receptor - agonists; Heart Failure - drug therapy; Heart Failure - epidemiology; Heart Failure - mortality; Humans; Hypoglycemic Agents - therapeutic use; Male; Middle Aged; Retrospective Studies; Sitagliptin Phosphate - therapeutic use; Treatment Outcome
• ISSN: 0167-5273; 1874-1754; 1874-1754
• DOI: 10.1016/j.ijcard.2024.132611

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. 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. 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