SGLT2is vs. GLP1RAs Reduce Cardiovascular and All-Cause Mortality

Mei Qiu; Xu-Bin Wei; Wei Wei

doi:10.3389/fcvm.2021.791311

SGLT2is vs. GLP1RAs Reduce Cardiovascular and All-Cause Mortality

Front Cardiovasc Med. 2021 Dec 7:8:791311. doi: 10.3389/fcvm.2021.791311. eCollection 2021.

Authors

Mei Qiu¹, Xu-Bin Wei², Wei Wei³

Affiliations

¹ Department of General Medicine, Shenzhen Longhua District Central Hospital, Shenzhen, China.
² Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
³ Department of Pharmacy, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.

Abstract

Lin et al. recently did a network meta-analysis based on cardiovascular (CV) outcome trials (CVOTs) of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and those of glucagon-like peptide-1 receptor agonists (GLP1RAs). Due to the absence of CVOTs directly comparing SGLT2is with GLP1RAs, Lin et al.'s network meta-analysis identified the indirect evidence that SGLT2is vs. GLP1RAs reduced hospitalization for heart failure (HHF) but did not reduce CV death and all-cause mortality (ACM) in patients with type 2 diabetes (T2D). We did another meta-analysis incorporating those CV outcome cohort studies directly comparing SGLT2is with GLP1RAs, and identified that SGLT2is vs. GLP1RAs were significantly associated with the lower risks of not only HHF but also CV death and ACM. These findings may suggest that SGLT2is should be considered over GLP1RAs in terms of preventing CV and all-cause death and HHF in T2D patients.

Keywords: GLP1Ras; SGLT2is; cardiovascular; death; renal; type 2 diabetes.