Introduction: SGLT2 inhibitors (SGLT2) and GLP1 agonists (GLP1) reduce major adverse cardiovascular events (MACE) in patients with T2D and MI. We examined prescription rates of these medications stratified by hemoglobin A1c at time of index MI admission in a large urban safety net teaching hospital which provided these medications to low income patients at nominal cost.
Methods: Using the hospital EHR, we reviewed medication lists one year after discharge for all patients with T2D who were hospitalized with type 1 MI between 2018-2019.
Results: There were 178 patients with one-year follow-up data, of which 75 (42%) were uninsured. As shown in Figure 1, proportions of patients prescribed SGLT2 and GLP1 at one year increased with higher admission A1c (p = 0.009 and p = 0.07, respectively). Median A1c at time of index MI was higher in those prescribed SGLT2 (9.3 vs 8.0, p = 0.03) and GLP1 (10.1 vs 8.1, p = 0.07) at one year versus those were not.
Conclusion: Patients with higher A1c at the time of MI were statistically significantly more likely to be prescribed SGLT2 and numerically more likely to be prescribed GLP1 one year after MI. These results suggest that a focus on glycemic control may be contributing to suboptimal use of these MACE-reducing medications in patients who would be expected to benefit from them.
C.L.Malladi: None. S.Das: None. N.Sumarsono: None. P.L.Della-penna: None. A.A.Dweik: None. K.Geurink: None. C.Mathew: None. E.Moss: None. K.Peykova: None. L.Mack-boyd: None.
