The Effect of SGLT-2 inhibitors and GLP-1RA on Major Cardiovascular Conditions: A Meta-Analysis

Abstract Objective Sodium-glucose co-transporter 2 (SGLT-2) inhibitors and Glucagon-like Peptide-1 Agonists (GLP-1RA) are two common anti-hyperglycemic agents prescribed by clinicians. The effects on cardiovascular conditions such as heart failure (HF) hospitalization, stroke, myocardial infarctions, and other cardiovascular conditions are not well studied. The purpose of this study is to analyze existing data on the effect of SGLT-2 inhibitors and GLP-1RA on preventing these cardiovascular conditions. Methods A retrospective meta-analysis of all existing literature of the effect of SGLT-2 inhibitors and GLP-1RA on the rates of the following categories was researched: primary cardiovascular outcomes, heart failure hospitalizations, atrial fibrillation, stroke, myocardial infarction, left ventricle ejection fraction (LVEF), and heart failure symptoms. Hazard ratios for each category were obtained, and overall Hazard Ratio (HR)’s to determine overall statistical significance were computed. Result Both medication classes provided statistically significant reduction in preventing major cardiovascular events. Only SGLT-2 inhibitors provided statistically significant reduction in heart failure hospitalizations. Only GLP-1RA provided statistically significant reduction in preventing stroke. Neither medication class provided a statistically significant benefit in preventing myocardial infarctions or improving LVEF. More studies are needed on effects of either SGLT-2 inhibitors or GLP-1RA agonists on preventing HF symptoms or atrial fibrillation. Conclusion This study demonstrates that SGLT-2 inhibitors and GLP-1RA are important for improving both diabetic and cardiovascular health. In patients at risk for a major cardiovascular event, SGLT-2 inhibitors or GLP-1RA may be prescribed by clinicians. More studies must be performed to draw more conclusions.