What question did this study set out to answer?

To evaluate the long-term effects of combined GLP-1RA and SGLT2i therapy on cardiovascular outcomes and healthcare costs in type 2 diabetes.

April 30, 2026European Heart Journal - Imaging Methods and Practice0 citationsOpen Access

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Myocardial deformation links combined liraglutide–empagliflozin therapy with improved cardiovascular and economic outcomes in type 2 diabetes: a 6-year study

JTJ Thymis GOGrigoris Oikonomidis GGGeorgios Georgiopoulos

Puntos clave

To evaluate the long-term effects of combined GLP-1RA and SGLT2i therapy on cardiovascular outcomes and healthcare costs in type 2 diabetes.
Enrolled 336 participants with type 2 diabetes, aged approximately 60 years
Measured Left Ventricular Global Longitudinal Strain at baseline and 6 months via echocardiography
Followed participants for 6 years to record non-fatal cardiovascular events
Applied multivariable Cox regression to assess treatment group's association with outcomes
Conducted cost analysis per treatment group
At 6 months, LVGLS improved significantly in the combination therapy group (p=0.020)
The combination therapy had the lowest risk of cardiovascular events compared to other treatments (HR=4.36 for insulin vs combination, p<0.001)
Improvement in LVGLS was an independent predictor of reduced cardiovascular risks (HR=0.89, p=0.040)
Combination therapy demonstrated the lowest monthly cost per patient (175€, 95% CI: 30-321)

Resumen

Abstract Aims We investigated whether the early favorable effects of combined GLP-1 receptor agonist (GLP-1RA) and SGLT2 inhibitor (SGLT2i) therapy in left ventricular deformation is associated with long-term cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM). We also addressed the healthcare costs. Methods We enrolled 336 consecutive participants with T2DM, aged 60±10 years old, 252/336 (75%) were males and were categorized into four groups: insulin, liraglutide, empagliflozin and liraglutide+empagliflozin. We measured at baseline and at 6 months Left Ventricular Global Longitudinal Strain (LVGLS) via echocardiography. Patients were followed for 6 years and we recorded the incidence of composite endpoint of non-fatal cardiovascular events (myocardial infarction, heart failure hospitalization, ischemic stroke and coronary revascularization). Multivariable Cox regression models were built to assess associations between treatment groups, LVGLS changes and outcomes. A cost analysis was also conducted. Results At 6 months LVGLS increased significantly (p=0.020), with the greatest improvement observed in the combination group compared with insulin, GLP-1RA, and SGLT2i groups (p0.05). At 6-year follow-up, 92 events were recorded. Combination therapy was associated with the lowest risk of events (Insulin vs Combination: HR=4.36,95%CI:2.04-9.33,p0.001; GLP1-RA vs Combination: HR=2.45, 95%CI:1.06-5.64, p=0.035; SGLT2i vs Combination: HR=3.07, 95%CI:1.38-6.81, p=0.006). In combination group, improvement of LVGLS independently predicted reduced event risk (HR=0.89, 95%CI:0.79-0.98,p=0.040). Combination group demonstrated the lowest mean cost per patient per month (Insulin:691€, 95%CI:472-911; GLP1-RA:224€, 95%CI:44-404; SGLT2i:528€,95%CI:305-751;Combination:175€, 95%CI: 30-321). Conclusion Combined GLP-1RA and SGLT2i therapy is associated with early improvement in myocardial deformation, which translates into reduced long-term cardiovascular risk and favorable economic outcomes.

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Cite This Study

Thymis et al. (Fri,) studied this question.

synapsesocial.com/papers/69f2a42a8c0f03fd67763379 https://doi.org/https://doi.org/10.1093/ehjimp/qyag080

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