Abstract
Background
Glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment reduces cardiovascular events in type 2 diabetes. Yet, the impact of GLP-1RA treatment before ST-segment elevation myocardial infarction (STEMI) on long-term prognosis in patients with type 2 diabetes remains unclear. In patients with STEMI and type 2 diabetes, we aimed to investigate the association between long-term prognosis and GLP-1RA treatment before STEMI.
Methods
This nationwide cohort study included consecutive patients admitted with type 2 diabetes and STEMI in Denmark from 2010 to 2016. All data were retrieved from nationwide Danish registries. Type 2 diabetes was defined by prior hospital admission with type 2 diabetes or anti-diabetic prescriptions within one year before STEMI. Dispensed GLP-1RA medication was retrieved within one year before STEMI.
Results
Of 1421 patients with STEMI and diabetes, 7% were treated with GLP-1RA before STEMI and 93% were not. Patients treated with GLP-1RA were younger, had more comorbidities, and more often treated with other anti-diabetics. During 8.4 years, 36% patients treated with GLP-1RA died whereas 52% died in the no GLP-1RA group (p = 0.002). In adjusted Cox analysis, GLP-1RA was associated with lower long-term mortality (hazard ratio (HR) 0.60, 95% confidence interval (CI) 0.43–0.84). There was no association between GLP-1RA and ischemic stroke (adjusted HR 1.05, 95% CI 0.57–1.94), recurrent myocardial infarction (adjusted HR 0.74, 95% CI 0.48–1.15), or hospitalisation for heart failure (adjusted HR 0.71, 95% CI 0.48–1.05).
Conclusions
In patients with diabetes and STEMI, GLP-1RA treatment prior to STEMI admission was associated with significantly lower long-term mortality.
Glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment reduces cardiovascular events in type 2 diabetes. Yet, the impact of GLP-1RA treatment before ST-segment elevation myocardial infarction (STEMI) on long-term prognosis in patients with type 2 diabetes remains unclear. In patients with STEMI and type 2 diabetes, we aimed to investigate the association between long-term prognosis and GLP-1RA treatment before STEMI.
Methods
This nationwide cohort study included consecutive patients admitted with type 2 diabetes and STEMI in Denmark from 2010 to 2016. All data were retrieved from nationwide Danish registries. Type 2 diabetes was defined by prior hospital admission with type 2 diabetes or anti-diabetic prescriptions within one year before STEMI. Dispensed GLP-1RA medication was retrieved within one year before STEMI.
Results
Of 1421 patients with STEMI and diabetes, 7% were treated with GLP-1RA before STEMI and 93% were not. Patients treated with GLP-1RA were younger, had more comorbidities, and more often treated with other anti-diabetics. During 8.4 years, 36% patients treated with GLP-1RA died whereas 52% died in the no GLP-1RA group (p = 0.002). In adjusted Cox analysis, GLP-1RA was associated with lower long-term mortality (hazard ratio (HR) 0.60, 95% confidence interval (CI) 0.43–0.84). There was no association between GLP-1RA and ischemic stroke (adjusted HR 1.05, 95% CI 0.57–1.94), recurrent myocardial infarction (adjusted HR 0.74, 95% CI 0.48–1.15), or hospitalisation for heart failure (adjusted HR 0.71, 95% CI 0.48–1.05).
Conclusions
In patients with diabetes and STEMI, GLP-1RA treatment prior to STEMI admission was associated with significantly lower long-term mortality.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 4 |
| Tidsskrift | Cardiovascular Diabetology |
| Vol/bind | 24 |
| Udgave nummer | 1 |
| Antal sider | 9 |
| ISSN | 1475-2840 |
| DOI | |
| Status | Udgivet - 2025 |
Bibliografisk note
Publisher Copyright:© The Author(s) 2025.