SGLT2i‒GLP1ra combo reduces risk of heart failure, mortality

Combination therapy with sodium-glucose transporter inhibitors (SGLT2i) and glucagon-like peptide receptor agonists (GLP1ra) prevents heart failure and improves long-term survival in a real-world population as compared with SGLT2i or GLP1ra monotherapy, according to a study.

The researchers used integrated electronic medical records from primary care and hospitals in a healthy area in Galicia for this nonconcurrent prospective study. Patients who received SGLT2i, GLP1ra, or both treatments between January 2018 and June 2022 were included in the analysis and were grouped into mono- or combined therapy.

Kaplan-Meier curves and multivariate Cox regression were used to calculate the hazard ratio (HR) and 95 percent confidence interval (CI) for the cumulative risks of hospitalization or mortality, or both, for heart failure, coronary artery disease, cerebrovascular accident, and all-cause mortality. The research team validated the results in a subpopulation with propensity score matching.

A total of 15,549 patients (median age 68 years, 41 percent female) met the eligibility criteria. Of these, 46 percent had obesity. The median follow-up was 19 months.

In Kaplan-Meier analysis, the three treatment groups demonstrated a similar cumulative risk for coronary artery disease and cerebrovascular accident events. However, SGLT2i plus GLP1ra was able to lower the risk of heart failure events (HR, 0.69, 95 percent CI, 0.56‒0.87) or all-cause mortality (HR, 0.68, 95 percent CI, 0.54‒0.86) compared with SGLT2i alone.

Results from the multivariate Cox regression analysis supported the benefits derived from the combined treatment relative to monotherapy.