Trends in prognosis and use of SGLT2i and GLP-1 RA in patients with diabetes and coronary artery disease
Main finding · MACEResult — go to the resultAdjusted hazard ratio 1.10 95% CI 1.03–1.17Authors' conclusion
The prescription pattern of diabetes medication is changing quickly in patients with diabetes and CAD; however, there are worrying signals of inefficient use prioritizing cardioprotective GLD to younger and healthier individuals at lower cardiovascular risk. Despite this, there are improving trends in 1-year morbidity.
Study context
- Population
- Patients with diabetes and coronary artery disease (CAD) undergoing coronary angiography 2010–2021, Sweden; 31% stable CAD, 69% acute MI; mean age 69 years, 67% male, 81% on glucose-lowering drugs (GLD)
- Participants
- 38,671 patients
- Exposure
- Other GLD vs cardioprotective GLD
- Outcome
- MACE:
- Mortality
- MI
- Stroke
- HF
- Follow-up
- Through December 2021
Methodological detailsnationwide, Swedish Angiography and Angioplasty Registry
- Nationwide
- Swedish Angiography and Angioplasty Registry
Main finding
MACE
Adjusted hazard ratio
1.10
95% CI 1.03–1.17
P = 0.004
Other GLDvs Cardioprotective GLD
aHR 1.10 (95% CI 1.03–1.17); P = 0.004
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Trend in 1-year MACE (year 2019 vs 2010) | 0.90 (0.81–1.00) | P = 0.045 | |
| 0.512Hazard ratio (log scale) |
Use of cardioprotective GLD over time · 2016-2021
- Use of cardioprotective GLD increased rapidly
- 7-47%
Characteristics of cardioprotective vs other GLD users
- Age, cardioprotective vs other GLD (years)
- 66 vs. 68
- Men, cardioprotective vs other GLD
- 72.9% vs. 67.1%
- History of HF, cardioprotective vs other GLD
- 5.0% vs. 6.8%
- History of MI, cardioprotective vs other GLD
- 7.7% vs. 10.5%
- CKD, cardioprotective vs other GLD
- 3.7% vs. 5.2%
Trend in 1-year major cardiovascular events (MACE) (year 2019 vs 2010)
- 1-year mortality unchanged
Original publication
Trends in prognosis and use of SGLT2i and GLP-1 RA in patients with diabetes and coronary artery disease. Cardiovasc Diabetol. Published 7 August 2024. doi:10.
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