Impact of glp-1 receptor agonists on hospitalization for heart failure and all-cause death in patients with diabetes with and without heart failure: a real-world study.
Luisa Ojeda-Fernández, Ginevra Torrigiani, Mauro Molteni, Ida Fortino, Claudio Cimminiello, Marta Baviera
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引用次数: 0
Abstract
Objective: Evidence on the impact of GLP-1 RAs on HF hospitalization (HHF) and mortality has been inconsistent across clinical trials in patients with diabetes. We investigated the association between GLP-1 RAs and these outcomes in a real-world setting.
Methods: We selected individuals aged 45 years and older already treated with metformin living in Lombardy, Italy, and then split them into two groups if they initiated GLP-1 RAs or other antidiabetic drugs, between 2019 and 2021. A multivariable Cox proportional hazard regression model was performed to assess the association of GLP-1 RAs on HHF and all-cause death as hazard ratios (HRs) with 95% CI compared to the Other ADs group, stratifying by history of HF. The role of GLP-1 RAs was also investigated using the Inverse Probability Treatment Weighting (IPTW) and in the subgroup analyses.
Results: In total, 9795 patients in the GLP-1 RAs group (302 with HF; 9493 without) and 6018 in the Other ADs group (405 with HF; 5613 without) were included in the analysis. GLP-1 RAs use was significantly associated with a lower risk of HHF in patients with a history of HF (HR 0.65; CI 95% 0.426-0.987) and in those without (HR 0.52; CI 95% 0.371-0.733). A lower risk for all-cause death was also observed in GLP-1 RAs users (with HF: HR 0.45; CI 95% 0.320-0.638; without HF: HR 0.44; CI 95% 0.383-0.514). The results of the IPTW and subgroup analyses confirmed those of the main analysis.
Conclusion: Our findings showed a benefit of GLP-1 RAs on HHF and all-cause death in patients with diabetes regardless of HF history. Although, our study presents several limitations, if confirmed through dedicated randomized trial, this could further expand the role of GLP-1RAs in cardiovascular prevention".
期刊介绍:
Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery.
As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.