GLP-1 receptor agonists-SGLT-2 inhibitors combination therapy and cardiovascular events after acute myocardial infarction: an observational study in patients with type 2 diabetes
Authors' conclusion
The combination of SGLT-2i and GLP-1RA is associated with a reduced incidence of cardiovascular events in patients with T2D and AMI compared with either drug used alone, with a significant effect also on peri-infarcted myocardial rescue in patients without a second event.
Study context
- Population
- Patients with T2D and acute myocardial infarction (AMI) undergoing percutaneous coronary intervention, treated with SGLT-2i or GLP-1RA for ≥3 months before hospitalization443 completed follow-up
- Participants
- 537 patients
- Exposure
- SGLT-2i/GLP-1RA combination therapy vs SGLT-2i or GLP-1RA alone
- SGLT-2i/GLP-1RAn = 214
- SGLT-2in = 99reference
- GLP-1RAn = 130reference
- Outcome
- Incidence of major adverse cardiovascular events (MACE):
- Cardiovascular death
- Re-acute coronary syndrome
- HF related to AMI
- Follow-up
- 2-year follow-up
Methodological detailsmultivariable Cox regression adjusted for cardiovascular risk factors
- Multivariable Cox regression adjusted for cardiovascular risk factors
Main finding
As reported in the abstract
MACE
Hazard ratio (95% CI)P value
SGLT-2i/GLP-1RAvs GLP-1RA
0.154(0.038–0.622)
P = 0.009SGLT-2i/GLP-1RAvs SGLT-2i
0.170(0.046–0.633)
P = 0.008Observational data: associations, not effects.
Further findings
Myocardial salvage index (MSI) and proportion with MSI > 50% · 3 months
- MSI and proportion with MSI > 50% higher with SGLT-2i/GLP-1RA vs both SGLT-2i and GLP-1RA
Original publication
GLP-1 receptor agonists-SGLT-2 inhibitors combination therapy and cardiovascular events after acute myocardial infarction: an observational study in patients with type 2 diabetes. Cardiovasc Diabetol. Published 6 January 2024. doi:10.
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