Effects of GLP-1RA Treatment on Long-Term Post-PCI Prognosis in T2DM Patients: A Propensity Score Matching Study

Abstract

Binbin Fang,1,&ast; Fen Liu,1,&ast; Junyi Luo,2 Ning Song,2 Chang Liu,2 Wei Ji,2 Xin An,2 Qian Xie,2 Yining Yang,3 Xiaomei Li2 1State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, People’s Republic of China; 2The First Department of Coronary Heart Disease, Heart Center of the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, People’s Republic of China; 3Department of Cardiology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiaomei Li, The First Department of Coronary Heart Disease, Heart Center of the First Affiliated Hospital of Xinjiang Medical University, 137 Liyushan South Road, Urumqi, 830054, People’s Republic of China, Tel [phone], Email [email protected] Yining Yang, Department of Cardiology, People’s Hospital of Xinjiang Uygur Autonomous Region, 91 Tianchi Road, Urumqi, 830054, People’s Republic of China, Tel [phone], Email [email protected]: Data on the effect of GLP-1RA treatment on the long-term prognosis of patients with diabetes after percutaneous coronary intervention (PCI) are scant. The purpose of this study was to evaluate the effect of GLP-1RA treatment on the long-term prognosis in T2DM patients after PCI.Patients and Methods: Data on T2DM patients who underwent PCI from January 2019 to December 2020 were retrospectively analyzed. Clinical data and the use of hypoglycaemic drugs were collected. Patients were divided into 2 groups based on whether they were treated with GLP-1RAs: the control group and the GLP-1RA group. PSM was used to match the control group at a 1:1 ratio. Survival curve and univariate and multivariate Cox regression analyses were used to compare the effects of GLP-1RA treatment on prognosis.Results: A total of 981 patients were enrolled, and 277 pairs (554 patients) were matched with propensity scores. The balance between two groups improved after PSM (P> 0.05). Compared with the control group, patients in the GLP-1RA group had lower TC, LDL-C, and HbA1c levels (P< 0.05). After 24 months of follow-up, a total of 93 patients experienced adverse cardiovascular events. The survival curve revealed that the event-free survival rate in the GLP-1RA group was greater than that in the control group (log rank P=0.012). Univariate and multivariate Cox regression analyses revealed that BMI (HR: 1.055, 95% CI=1.007– 1.105), HDL-C levels (HR: 0.236, 95% CI=0.095– 0.583) and GLP-1RA use (HR: 0.617, 95% CI=0.403– 0.943) were independent influencing factors of post-PCI major adverse cardiovascular event (MACE) risk in T2DM patients (P< 0.05).Conclusion: GLP-1RA treatment demonstrates cardiovascular benefits in T2DM patients following PCI, effectively reducing the risk of MACE, and enhancing long-term prognosis.Keywords: GLP-1 receptor agonist, percutaneous coronary intervention, long-term prognosis, ischemic heart disease

Keywords

• GLP-1 receptor agonist
• Percutaneous coronary intervention
• Long-term prognosis
• Ischemic heart disease