Real-world cardiovascular effectiveness of sustained glucagon-like peptide 1 GLP-1 receptor agonist usage in type 2 diabetes
Main finding · 3P-MACEResult — go to the resultRisk reduction 2.5% 95% CI 0.8–4.1%Authors' conclusion
This real-world study confirms the cardiovascular benefits of GLP1-RAs over DPP-4is, particularly for reducing cardiovascular and all-cause mortality under continuous treatment exposure in patients with type 2 diabetes at increased cardiovascular risk.
Study context
- Population
- Individuals with T2D mirroring the LEADER trial inclusion and exclusion criteria, Denmark, 2012–2022
- Participants
- 6,681 vs 19,072
- Exposure
- Sustained GLP-1 RA use vs DPP-4i
- GLP1-RAn = 6,681
- DPP-4in = 19,072reference
- Outcome
- 3P-MACE: composite of MI, stroke and cardiovascular mortality
- Follow-up
- 3.5 years
Methodological detailsDanish nationwide registries, active comparator, Longitudinal Targeted Minimum Loss-based Estimation, adjusted for baseline and time-varying confounding
- Danish nationwide registries
- Active comparator
- Longitudinal Targeted Minimum Loss-based Estimation
- Adjusted for baseline and time-varying confounding
Main finding
3P-MACE
Risk reduction
2.5%
95% CI 0.8–4.1%
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Risk reduction (95% CI) |
|---|---|
| CV mortality · 3.5 years | 2.3% (1.4–3.1%) |
| All-cause mortality · 3.5 years | 2.5% (0.7–4.3%) |
| HF · 3.5 years | 0.9% (0.01–1.8%) |
| Unstable angina pectoris · 3.5 years | 0.7% (0.01–1.3%) |
- CV mortality: sustained use; adjusted for baseline and time-varying confounding
- All-cause mortality: sustained use; adjusted for baseline and time-varying confounding
- HF: sustained use; adjusted for baseline and time-varying confounding
- Unstable angina pectoris: sustained use; adjusted for baseline and time-varying confounding
MI
- No significant difference; risk difference
- 0.1% (−1.0 to 0.8%) (95% CI)
Stroke
- No significant difference; risk difference
- 0.8% (−0.2 to 1.7%) (95% CI)
Revascularization
- No significant difference; risk difference
- 0.2% (−0.7-1.1%) (95% CI)
Original publication
Real-world cardiovascular effectiveness of sustained glucagon-like peptide 1 GLP-1 receptor agonist usage in type 2 diabetes. Cardiovasc Diabetol. Published 6 October 2025. doi:10.
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