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Cardiovascular and mortality benefits of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists as third-step glucose-lowering medicine in patients with type 2 diabetes: a retrospective cohort analysis
Heart and survival benefits of two diabetes medicines used after initial treatments in type 2 diabetes
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Abstract
27,542 patients with type 2 diabetes and cardiovascular conditions were analyzed for third-step treatment outcomes.
- Adjusted rate ratios (ARRs) for all-cause mortality ranged from 0.22 to 0.55 for patients using GLP1 or SGLT2 compared to those using DPP4, insulin, or thiazolidinediones.
- For major adverse cardiovascular events (MACE), ARRs were between 0.38 and 0.81 when comparing GLP1 or SGLT2 to alternative treatments.
- Incidence rates for heart failure hospitalization showed ARRs between 0.46 and 1.05 for GLP1 or SGLT2 versus DPP4, insulin, or TZD.
- Many of the observed ARRs were statistically significant, indicating a potential benefit (ARR <1) for GLP1 or SGLT2 compared to other medications.
- Findings suggest that third-step SGLT2 and GLP1 may offer cardiovascular advantages for patients with type 2 diabetes and related conditions.
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Key numbers
0.22 to 0.55
Decrease in All-Cause Mortality
Adjusted rate ratios for mortality comparing GLP1 and SGLT2 to DPP4, insulin, or TZD.
0.38 to 0.81
Decrease in Major Adverse Cardiovascular Events (MACE)
Adjusted rate ratios for MACE comparing GLP1 and SGLT2 to other treatments.
0.46 to 1.05
HF Hospitalization Rate
Adjusted rate ratios for HF hospitalization comparing GLP1 and SGLT2 to other treatments.