Comparative Outcomes of Glucagon‐Like Peptide‐1 Receptor Agonists to Dipeptidyl Peptidase 4 Inhibitors in Patients With Heart Failure and Type 2 Diabetes

Abstract

Background Clinical trials showed that glucagon‐like peptide‐1 receptor agonist (GLP1‐RA) significantly improved the control of diabetes and reduced body weight compared with dipeptidyl peptidase 4 inhibitor (DPP‐4i). However, it is unclear whether GLP1‐RA is effective compared with DPP‐4i in patients with heart failure (HF) with type 2 diabetes (T2D). The purpose of this study was to evaluate the risk of GLP1‐RA compared with DPP‐4i in all‐cause death and hospitalization in patients with HF and T2D. Methods This multicenter retrospective observational study using TriNetX, a global health care data and analytics platform, included patients with HF and T2D who had received GLP1‐RA or DPP‐4i from January 1, 2018, to December 31, 2022. Primary outcome was 12‐month incidence of all‐cause death. Secondary outcome was hospitalization. We used odds ratios (ORs) and 95% CIs to evaluate outcome measures. Results Among 1 005 097 patients with HF and T2D, 57 965 initiated GLP1‐RA and 77 098 initiated DPP‐4i. After propensity score matching, the number of participants in both the GLP1‐RA group and the DPP‐4i group was 36 557. The proportion of 12‐month incidence of all‐cause death was lower in the GLP1‐RA group than in the DPP‐4i group (5.9% [2140/36 557] versus 8.5% [3103/36 557]; OR, 0.67 [95% CI, 0.63–0.71]).The proportion of 12‐month incidence of hospitalization was also lower in the GLP1‐RA group than in the DPP‐4i group (42.3% [15 455/36 557] versus 48.5% [17 733/36 557]; OR, 0.78 [95% CI, 0.76–0.80]). Conclusions Use of GLP1‐RA for patients with HF and T2D was associated with reduced 12‐month incidence of all‐cause death and hospitalization compared with DPP‐4i.

Keywords

• dipeptidyl peptidase 4 inhibitor
• glucagon‐like peptide‐1 receptor agonist
• heart failure
• type 2 diabetes