Pharmacological Treatments

Cardiovascular Impact of GLP-1 RAs and SGLT-2i in T2DM


European Journal of Medical Research


Cardiovascular Impact of GLP-1 RAs and SGLT-2i in T2DM

Summary

This study systematically reviewed and analyzed randomized controlled trials (RCTs) evaluating the cardiovascular effects of SGLT-2 inhibitors and GLP-1 receptor agonists in type 2 diabetes patients, both with and without baseline metformin use. Results indicated that these drugs reduce major adverse cardiovascular events (MACE), hospitalization for heart failure (HHF), and cardiovascular death regardless of metformin use.

Study Design

Interventions

DapagliflozinEmpagliflozinLiraglutideSemaglutide

Study Type

Meta-AnalysisSystematic Review

Outcomes

Reduction in cardiovascular deathReduction in hospitalization for heart failure (HHF)Lower incidence of MACEReduction in stroke incidence

Duration and Size

Long-Term (1–5 y)
Mega size (5000+)

Study Population

Age Range

Middle Aged (40-64)

Sex

MaleFemale

Geography

Global

Other Criteria

with T2 Diabetes

Methodology

Following PRISMA guidelines, four databases were systematically searched for RCTs assessing cardiovascular outcomes in T2DM patients using SGLT-2i or GLP-1 RAs. Data extraction focused on major adverse cardiovascular events and secondary endpoints.

Interventions

Interventions included SGLT-2 inhibitors such as dapagliflozin and empagliflozin, and GLP-1 receptor agonists like liraglutide and semaglutide, analyzed for cardiovascular outcomes.

Key Findings

Both drug classes reduced cardiovascular risks independently of baseline metformin use, with no significant interaction effects detected.

Comparison with other Studies

Comparisons with previous CVOTs confirm these drugs' cardioprotective effects regardless of metformin usage.

Journal Reference

Zhang Y, Li Z, Hao Y. Comparative efficacy of GLP-1 RAs/SGLT-2 inhibitors in reducing cardiovascular events in type 2 diabetes. Eur J Med Res. 2025;30:13. doi:10.1186/s40001-024-02241-4.

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