TYPE 2 diabetes patients with established cardiovascular disease experienced a lower risk of recurrent major adverse cardiovascular events (MACE) when cardioprotective glucose-lowering drugs were used alongside statins, according to findings presented at the European Atherosclerosis Society (EAS) Congress.
Cardioprotective Drugs and Cardiovascular Risk
Despite strong evidence supporting both treatment approaches individually, uptake of cardioprotective glucose-lowering drugs and statins remains suboptimal in routine clinical practice.
While sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists are known to reduce cardiovascular risk in patients with Type 2 diabetes, no randomised trials have directly examined whether combining these therapies with statins provides additional benefit.
Researchers therefore investigated whether combining cardioprotective glucose-lowering drugs with statins was associated with a lower risk of secondary MACE than either treatment alone.
Secondary MACE refers to recurrent cardiovascular events occurring in individuals who already have established cardiovascular disease. These events typically include myocardial infarction, stroke, or cardiovascular death, all of which remain major causes of morbidity and mortality in patients with Type 2 diabetes.
Real-World Data from Danish Health Registers
The investigators identified individuals with Type 2 diabetes and established cardiovascular disease using Danish national health registers from 2012–2021.
Two complementary analyses were conducted: an active comparator cohort including 15,404 individuals and a larger time-varying cohort involving 76,853 individuals with yearly treatment updates.
Participants were followed for a mean of 2.7 years and 4.7 years in the two cohorts, during which 1,843 and 23,051 major adverse cardiovascular events occurred, respectively.
Combination Therapy Showed Greater Benefits
Compared with individuals not receiving either treatment, the active comparator cohort showed reduced risk of recurrent cardiovascular events with cardioprotective glucose-lowering drugs alone (hazard ratio [HR]: 0.82; 95% confidence interval [CI]: 0.66–1.01) and statins alone (HR: 0.84; 95% CI: 0.74–0.97).
However, the greatest reduction was observed with combined therapy (HR: 0.71; 95% CI: 0.60–0.83).
Similar findings emerged from the larger time-varying cohort, where cardioprotective glucose-lowering drugs alone (HR: 0.76; 95% CI: 0.68–0.85), statins alone (HR: 0.73; 95% CI: 0.70–0.75), and combined therapy (HR: 0.57; 95% CI: 0.54–0.60) were all associated with lower risk.
Implications for Clinical Practice
Although no statistically significant interaction was identified between the two treatment classes, the findings suggest that combining cardioprotective glucose-lowering drugs with statins may provide cumulative benefits for patients with Type 2 diabetes and established cardiovascular disease.
The results highlight a potential opportunity to reduce recurrent cardiovascular events through wider implementation of treatments already recommended in clinical practice.
Reference
Ternhamar T et al. Cardioprotective glucose-lowering drugs, statins, and secondary major adverse cardio-vascular events. 94th EAS Congress, 24-27 May, Athens.
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