Time-dependent effect of GLP-1 receptor agonists on cardiovascular benefits: a real-world study
Authors' conclusion
In this real-world type 2 diabetes population, discontinuation of GLP-1 RA treatment was associated to a higher risk of major cardiovascular events, in both subjects with and without a history of CV events.
Study context
- Population
- Persons with T2D followed at a single center after first GLP-1 RA prescription, 2009–2019, with and without a history of cardiovascular (CV) events
- Participants
- 550 persons
- Exposure
- GLP-1 RA cessation vs continuation
- Primary preventionn = 395
- Secondary preventionn = 155
- Outcome
- MACE risk with GLP-1 RA cessation by time
Methodological detailssingle-centre, multivariable Cox regression with GLP-1 RA treatment as time-dependent covariate
- Single-centre
- Multivariable Cox regression with GLP-1 RA treatment as time-dependent covariate
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
GLP-1 RA cessation (primary prevention)
3.40(1.82–6.32)
P < 0.001GLP-1 RA cessation (secondary prevention)
2.71(1.46–5.01)
P = 0.002Observational data: associations, not effects.
Further findings
MACE risk by age at GLP-1 initiation (primary prevention)
| HR (95% CI) | P value | ||
|---|---|---|---|
| Age at GLP-1 initiation | 1.08 (1.03–1.14) | P = 0.001 | |
| 0.512Hazard ratio (log scale) |
Follow-up and treatment duration
Median treatment duration Primary prevention 3.2 years (0-10.8) · Secondary prevention 2.5 years (0-10.3)
MACE risk by age at GLP-1 initiation (primary prevention)
- Changes in BMI and HbA1c did not have an impact on MACE risk (primary prevention)
Weight and HbA1c during follow-up
- Continuers had significantly greater weight loss and lower HbA1c than those who withdrew treatment
Original publication
Time-dependent effect of GLP-1 receptor agonists on cardiovascular benefits: a real-world study. Cardiovasc Diabetol. Published 25 March 2023. doi:10.
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