Real-world cardiovascular effectiveness of sustained glucagon-like peptide 1 GLP-1 receptor agonist usage in type 2 diabetes

作者：Kathrine Kold Sørensen, Puriya Daniel Würtz Yazdanfard, Bochra Zareini, Ulrik Pedersen‐Bjergaard, Vanja Kosjerina, Mikkel Porsborg Andersen, Anders Munch, Johan Sebastian Ohlendorff, Stefanie Schmid, Stefanie Lanzinger, Pratik Choudhary, Clare Gillies, Safoora Gharibzadeh, Marcus Lind, Viktor Tasselius, Jens Michelsen, Thomas Alexander Gerds, Christian Torp‐Pedersen · 发表于：Cardiovascular Diabetology · 年份：2025 · DOI：10.1186/s12933-025-02915-1 · 被引用次数：6 · 研究领域：Diabetes Treatment and Management、Heart Failure Treatment and Management、Hyperglycemia and glycemic control in critically ill and hospitalized patients

BACKGROUND: Cardiovascular outcome trials have shown that glucagon-like peptide 1 receptor agonists (GLP1-RAs) reduce cardiovascular event rates more effectively than placebo and in patients with type 2 diabetes at increased cardiovascular risk. However, the generalizability of these findings to real-world settings remains uncertain. AIM: This study aimed to evaluate the real-world cardiovascular effectiveness of sustained GLP1-RA use compared to dipeptidyl peptidase 4 inhibitor (DPP-4i) over 3.5 years. METHODS: Using Danish nationwide registries, we emulated a target trial to assess the real-world effectiveness of GLP1-RAs in a population of individuals with type 2 diabetes mirroring the inclusion and exclusion criteria from the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial. The study period was 2012-2022. Outcomes included the composite of myocardial infarction, stroke, and cardiovascular mortality (3P-MACE), as well as each component individually, alongside all-cause mortality, heart failure, angina pectoris, and revascularization. Longitudinal Targeted Minimum Loss-based Estimation, a method that adjusts for both baseline and time-varying confounding, was used to estimate absolute risks of cardiovascular outcomes under sustained use of GLP1-RA and DPP 4i (active comparator), adjusting for baseline and time-varying confounding. RESULTS: We included 6,681 people initiating GLP1-RA and 19,072 initiating DPP-4i. Account...