This study investigated cardiovascular outcomes by treatment group in participants randomly assigned to insulin glargine, glimepiride, liraglutide, or sitagliptin, added to baseline metformin, in GRADE (Glycemia Reduction Approaches in Type 2 Diabetes: A Comparative Effectiveness Study):
- total of 5047 participants with a mean±SD age of 57.2±10.0 years, type 2 diabetes duration of 4.0±2.7 years, and low baseline prevalence of cardiovascular disease (myocardial infarction, 5.1%; cerebrovascular accident, 2.0%) were followed for a median of 5 years
- prespecified outcomes included between-group time-to-first event analyses of
- MACE-3 (composite of major adverse cardiovascular events: cardiovascular death, myocardial infarction, and stroke),
- MACE-4 (MACE-3+unstable angina requiring hospitalization or revascularization),
- MACE-5 (MACE-4+coronary revascularization),
- MACE-6 (MACE-5+hospitalization for heart failure), and the individual components
- MACE outcomes and hospitalization for heart failure in the liraglutide-treated group were compared with the other groups
- found no significant differences in cumulative incidence of first MACE-3, MACE-4, MACE-5, or MACE-6, or individual components, by treatment group, but liraglutide group had lower risk of MACE-5, MACE-6 and heart failure hospitalisation vs other groups combined
- study authors concluded:
- comparative effectiveness study of a contemporary cohort of adults with type 2 diabetes, largely without established cardiovascular disease, suggests that liraglutide treatment may reduce the risk of cardiovascular events in patients at relatively low risk compared with other commonly used glucose-lowering medications
Reference:
- Green JB et al. Cardiovascular Outcomes in GRADE (Glycemia Reduction Approaches in Type 2 Diabetes: A Comparative Effectiveness Study). Circulation February 12th 2024