The combined use of SGLT2i and GLP-1RA was associated with a reduced risk of 1-year MACE compared to SGLT2i alone in T2D patients with ACS (HR 0.690; 95% CI 0.488-0.976).
Cohort (n=1,325)
No
Does the combination of SGLT2i and GLP-1RA reduce MACE in type 2 diabetes patients with acute coronary syndrome compared to SGLT2i alone?
In patients with type 2 diabetes and acute coronary syndrome, adding a GLP-1RA to background SGLT2i therapy was associated with a significantly lower risk of 1-year MACE compared to SGLT2i alone.
Hazard Ratio: 0.69 (95% CI 0.488–0.976)
BACKGROUND: Few studies have investigated the effect of the combined use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RA) on the cardiovascular (CV) composite outcomes in type 2 diabetes (T2D) patients with acute coronary syndrome (ACS). METHODS: We retrospectively collected the data of 1325 T2D patients treated with SGLT2i for more than 3 months before ACS admission at Civil Aviation General Hospital. According to the initiative GLP-1RA use after admission, patients were divided into a combination group (SGLT2i and GLP-1RA) or a SGLT2i group. The primary CV composite outcomes were defined as the first occurrence of major adverse cardiovascular events (MACE) with 1-year, encompassing all cause death, CV death, non-fatal myocardial infarction or stroke, coronary revascularization or heart failure readmission. Propensity score-matched (PSM) was used to control the confounding factors. RESULTS: After matching, 208 pairs were finally included. Compared with the SGLT2i group, the combination group demonstrated a 31.0 % reduced risk of MACE (HR = 0.690, 95 %CI: 0.488-0.976), attributed primarily to a substantial 22.9 % (HR = 0.771, 95 %CI: 0.599-0.992) reduction in all-cause mortality and a 36.3 % reduction in non-fatal stroke (HR = 0.637, 95 %CI: 0.413-0.982). Subgroup analyses indicated consistent CV benefits across different subgroups (P interaction values >0.05). CONCLUSIONS: The combined use of SGLT2i and GLP-1RA was associated with a significantly decreased risk of MACE primarily driven by the lowering risks of all-cause mortality and nonfatal stroke in T2D patients with ACS, compared with SGLT2i use alone.
Liu et al. (Sat,) conducted a cohort in Type 2 diabetes with acute coronary syndrome (n=1,325). SGLT2i and GLP-1RA combination vs. SGLT2i alone was evaluated on First occurrence of major adverse cardiovascular events (MACE) within 1-year, encompassing all cause death, CV death, non-fatal myocardial infarction or stroke, coronary revascularization or heart failure readmission (HR 0.690, 95% CI 0.488-0.976). The combined use of SGLT2i and GLP-1RA was associated with a reduced risk of 1-year MACE compared to SGLT2i alone in T2D patients with ACS (HR 0.690; 95% CI 0.488-0.976).
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