Sodium-Glucose cotransporter-2 inhibitors (SGLT-2i) and Glucagon-like peptide 1 receptor
agonists (GLP1-RA) have revolutionised the approach for modern management of type 2 diabetes in
view of their outcome altering abilities. An objective component of the primary endpoints used in the
Cardiovascular Outcome Trials (CVOT) is cardiovascular (CV) death. However, the reason behind the
decrease in CV deaths (compared to the placebo arm) appear to arise from divergent underlying processes.
A recent meta-analysis of SGLT-2i and GLP1-RA indicated that the reduction in CV death associated
with the former is predominantly due to its impact on heart failure (HF), while the association
with the latter is due to its effect on atherosclerotic cardiovascular disease (ASCVD). A Pearson’s product-
moment correlation coefficient (r) analysis was performed on SGLT-2i exposed to CVOTs,
exploring the strength of the association between CV death and hospitalisation for HF (hHF) and myocardial
infarction (MI). The strength of association was strongest with hHF and negative with MI. In
view of these findings, it has been proposed that future CVOTs should use a more objective definition
of CVD, defining well in advance the anticipated impact on CVD (either as a consequence of the reduction
in HF or ASCVD).
Keywords: CVOT, MACE, MI, hHF, SGLT-2i, CV death, type 2 diabetes, correlation coefficient.
Hee-Sook J. Anti-inflammatory effects of GLP-1-based therapies beyond glucose control. Mediators Inflamm 2016; 2016: 1-11.
Rajput R, Prakash A, Aggarwal R. Newer antidiabetic drugs in the pipeline. Int J Diab 2019; pp. 28-33.
Rights & PermissionsPrintExport