What does this research mean for the field?

GLP-1 receptor agonists significantly reduce major adverse cardiovascular events in Non-Hispanic White, Hispanic White, and Non-Hispanic Black populations but not in Asian populations, while SGLT2 inhibitors demonstrate no significant cardiovascular benefits across any of these racial or ethnic groups. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess major adverse cardiovascular events (MACE) associated with GLP-1RA and SGLT2i in diverse racial and ethnic groups.

June 7, 2026

4-PUB: Cardiovascular Benefits of GLP-1RA and SGLT2i across Different Populations

Key Points

To assess major adverse cardiovascular events (MACE) associated with GLP-1RA and SGLT2i in diverse racial and ethnic groups.
Retrospective analysis of 11,300 individuals with type 2 diabetes on antihyperglycemic medications.
MACE defined as cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, hospitalization for heart failure, and ischemia-driven revascularization.
Logistic regression used to evaluate MACE outcomes considering age, sex, race/ethnicity, type of antihyperglycemic, and comorbidities.
Non-Hispanic White population using GLP-1RA showed a 31.5% reduction in MACE outcomes compared to other antihyperglycemic medications.
Hispanic White and Non-Hispanic Black populations exhibited a 42.5% and 23.7% reduction in MACE, respectively.
The Asian population did not show significant benefits, and SGLT2i demonstrated no notable reduction in MACE across all ethnicities.

Abstract

Introduction and Objective: Cardiovascular (CV) disease is the leading cause of death in individuals over age 45 and adults with type 2 diabetes (T2D) have 2-4 times higher risk of CV morbidity and mortality. While the economic burden of CV disease is expected to increase by 2050, CV outcome trials highlighting beneficial effects of GLP-1RA and SGLT2i have failed to sufficiently include diverse race/ethnic patient populations. Hence, these benefits are yet to be quantified across populations. With this study, we aim to understand the major adverse CV events (MACE) across diverse populations using these pharmacotherapeutic agents. Methods: We retrospectively analyzed 11,300 individuals with T2D on antihyperglycemic medications and assessed MACE outcomes. MACE was defined using CV death, non-fatal myocardial infarction, non-fatal stroke, hospitalization for heart failure, and ischemia-driven revascularization. Logistic regression assessed MACE occurrence post-antihyperglycemic initiation, factoring in age, sex, race/ethnicity, type of antihyperglycemic (GLP-1RA, SGLT2i, or other), and associated comorbidities. Results: Non-Hispanic White (NHW) population using GLP-1RAs experienced a 31.5% reduction in MACE outcomes compared to those on other antihyperglycemic medications. While Hispanic White (HW) and NHB populations demonstrated a 42.5% and 23.7% reduction, respectively, the Asian (A) population did not notice statistically significant benefits in MACE outcomes. Furthermore, SGLT2i revealed no notable reduction in MACE across all race/ethnicities. Conclusion: GLP-1RA effectively reduced MACE risk among HW and NHB but not in the A population. Also, SGLT2i demonstrated no significant benefits. These results underscore the importance of tailored diabetes treatment and the need for further exploration into contributing disparities. Disclosure M. Brinson: None. F. Shehadeh: None. A. Sabharwal: None. A. Kansara: Research Support; Current; Eli Lilly and Company. Research Support; Ended; Medtronic. Research Support; Current; Arrowhead Pharmaceuticals, Calcilytix, Inc. Research Support; Ended; Amolyt. Research Support; Current; Endogenex. Advisory Panel; Ended; Veracyte, Crinetics Pharmaceuticals, Inc. Funding Digital Health Workshop Seed Award

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