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Introduction: SGLT2i (S) and GLP-1 RA (G) are both known to have well established cardio protective effects in patients with T2DM. However, the comparative CV efficacy of these drugs is not well known.

Methods: We used a national hospital-based database (Explorys Inc, IBM) to compare the CV outcomes (CVO) among patients receiving S or G. T2DM patients were divided in 3 groups- combination therapy (G+S), only G and only S. First, CVO were compared among G+S and the other two. Subsequently G and S were compared amongst themselves. OR and 95% CI were calculated for these CVO [(combination of acute MI (AMI), acute stroke (CVA), and acute HF (AHF)].

Results: G+S therapy (N= 59410) resulted in lower CVO when compared to isolated therapy with G (N = 143690) [3.4 % vs. 6.2%, OR 0.54 (0.51-0.56)] or S (N= 212560) [3.4 % vs. 6.7%, OR 0.50 (0.47-0.52)] (Table 1). Additionally, G had a slightly better outcome profile than S ([6.2 % vs. 6.7%, OR 0.92 (0.90-0.95)].

Conclusion: Combination therapy of SGLT2i and GLP-1 RA confers the highest CV risk mitigation when compared to isolated therapy (50% reduction in relative risk). Furthermore, isolated therapy with GLP-1 fared better than SGLT-2i. The latter was driven by a reduction in AMI and CVA. Heart failure outcomes were similar among the two. Prospective studies are needed to confirm these findings.

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Disclosure

O. A. Alaber: None. A. K. Chandar: None. A. Singh: None. A. Smer: None. N. Manivannan: None. S. A. Pitts: None. A. Rajpal: None.

© 2021 by the American Diabetes Association
2021
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