A recent cohort study found that sodium-glucose cotransporter 2 inhibitors were associated with reductions in the rate of total cardiovascular events, including recurrent events, in high-risk patients with type 2 diabetes. 

Conducted at National Cheng Kung University Hospital in Taiwan, the study compared sodium-glucose cotransporter 2 inhibitors (SGLT2is) with dipeptidyl peptidase 4 inhibitors (DPP4is) in terms of their association with total cardiovascular (CVD) burden among patients with type 2 diabetes (T2D).

Using data from 1,632 propensity score–matched pairs from 2016 to 2019, researchers observed an 18% lower rate of total CVD events associated with SGLT2i therapy compared to DPP4i therapy (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.69-0.98). Patients at high risk of recurrent CVD events, such as those with chronic kidney disease (CKD) or a history of CVD, saw even greater reductions, with decreases in total CVD burden reaching up to 30% (e.g., HR, 0.70 for patients with an estimated glomerular filtration rate below 60 mL/min/1.73 m²).

Specific reductions in the rates of heart failure (HR, 0.65; 95% CI, 0.49-0.86) and myocardial infarction (HR, 0.57; 95% CI, 0.34-0.95) were also observed with SGLT2i use compared to DPP4i. Among high-risk subgroups, including women with CKD, SGLT2i use was associated with a 43% reduction in the total CVD burden (HR, 0.43; 95% CI, 0.33-0.55) compared with male counterparts (HR, 0.84; 95% CI, 0.72-0.97).

Published in JAMA Network Open, the study’s authors noted that, despite evidence linking SGLT2i therapy with reduced cardiovascular events, these agents remain underutilized among high-risk T2D patients in clinical settings. Full author disclosures are available in the published article.

Full disclosures can be found in the published study.