GLP-1 receptor agonists in atherosclerotic cardiovascular disease and diabetes mellitus or obesity: investigation of the potential role in a German inpatient dataset.

Abstract

Background: GLP-1 receptor agonists (GLP-1 RA) reduce major adverse cardiovascular events in patients with diabetes mellitus and atherosclerotic cardiovascular disease (ASCVD) or increased cardiovascular risk. Recently, the GLP-1 RA semaglutide was reported to reduce cardiovascular events in ASCVD patients with overweight or obesity even in the absence of diabetes mellitus. Accordingly, this was included in the current European Society of Cardiology guidelines for secondary prevention. We aimed to assess the number of inpatients with ASCVD who could qualify for therapy with GLP-1 RA.

Methods: Using nationwide data from the Research Data Centre of the Federal Statistical Office of Germany, a random 10% sample of all adult inpatients in 2022 was analyzed. The proportions of ASCVD, obesity, and diabetes mellitus were examined.

Results: The 10% sample included 1,446,420 patients with a mean age of 63.16 years, 52.50% were female. ASCVD was present in 229,619 inpatients (15.87%), including those with coronary artery disease, history of myocardial infarction, peripheral vascular disease or stroke. Among ASCVD patients, 79,516 individuals (34.63% of ASCVD patients) also suffered from type 2 diabetes mellitus and 15,624 individuals were diagnosed with obesity. Approximately half of those (N = 7,256) had ASCVD and obesity without diabetes mellitus (3.16% of ASCVD patients). Overall, 37.79% of ASCVD patients also suffered from type 2 diabetes mellitus or obesity.

Conclusion: In this data sampling of German inpatients, more than one-third of ASCVD patients may qualify for GLP-1 RA therapy due to concomitant diabetes mellitus or obesity. That corresponds to about 6% of inpatients in Germany.