Evidence map›Paper›PMID 32522260›Full record

ArticleCardiovascular diabetology2020

Better cardiovascular outcomes of type 2 diabetic patients treated with GLP-1 receptor agonists versus DPP-4 inhibitors in clinical practice.

Enrico Longato, Barbara Di Camillo, Giovanni Sparacino, Lara Tramontan, Angelo Avogaro, Gian Paolo Fadini

Open access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 2 pooled it
4.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Enrico LongatoDepartment of Information Engineering, University of Padova, 35100, Padua, Italy.
Barbara Di CamilloDepartment of Information Engineering, University of Padova, 35100, Padua, Italy.
Giovanni SparacinoDepartment of Information Engineering, University of Padova, 35100, Padua, Italy.
Lara TramontanArsenàl.IT, Veneto's Research Centre for eHealth Innovation, 31100, Treviso, Italy.
Angelo AvogaroDepartment of Medicine, University of Padova, Via Giustiniani 2, 35100, Padua, Italy.
Gian Paolo FadiniDepartment of Medicine, University of Padova, Via Giustiniani 2, 35100, Padua, Italy. gianpaolo.fadini@unipd.it.ORCID 0000-0002-6510-2097
University of Padua · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiovascular outcome trials in high-risk patients showed that some GLP-1 receptor agonists (GLP-1RA), but not dipeptidyl-peptidase-4 inhibitors (DPP-4i), can prevent cardiovascular events in type 2 diabetes (T2D). Since no trial has directly compared these two classes of drugs, we performed a comparative outcome analysis using real-world data.

methodsFrom a database of ~ 5 million people from North-East Italy, we retrospectively identified initiators of GLP-1RA or DPP-4i from 2011 to 2018. We obtained two balanced cohorts by 1:1 propensity score matching. The primary outcome was the 3-point major adverse cardiovascular events (3P-MACE; a composite of death, myocardial infarction, or stroke). 3P-MACE components and hospitalization for heart failure were secondary outcomes.

resultsFrom 330,193 individuals with T2D, we extracted two matched cohorts of 2807 GLP-1RA and 2807 DPP-4i initiators, followed for a median of 18 months. On average, patients were 63 years old, 60% male; 15% had pre-existing cardiovascular disease. The rate of 3P-MACE was lower in patients treated with GLP-1RA compared to DPP4i (23.5 vs. 34.9 events per 1000 person-years; HR: 0.67; 95% C.I. 0.53-0.86; p = 0.002). Rates of myocardial infarction (HR 0.67; 95% C.I. 0.50-0.91; p = 0.011) and all-cause death (HR 0.58; 95% C.I. 0.35-0.96; p = 0.034) were lower among GLP-1RA initiators. The as-treated and intention-to-treat approaches yielded similar results.

conclusionsPatients initiating a GLP-1RA in clinical practice had better cardiovascular outcomes than similar patients who initiated a DPP-4i. These data strongly confirm findings from cardiovascular outcome trials in a lower risk population.

Indexed as

Glucagon-Like Peptide-1 Receptor AgonistsAgedCardiovascular DiseasesCause of DeathDatabases, FactualDiabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsFemaleGlucagon-Like Peptide-1 ReceptorHumansIncretinsItalyMaleMiddle AgedPatient AdmissionProtective FactorsDipeptidyl-Peptidase IV InhibitorsGLP1R protein, humanGlucagon-Like Peptide-1 ReceptorGlucagon-Like Peptide-1 Receptor AgonistsIncretinsDrug therapyEpidemiologyObservationalRegistry, outcome

Identifiers

PMID32522260
PMCPMC7288543
OpenAlexW3033887523

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.