Observational studyCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2026
Comparative Efficacy of GLP-1 RAs Versus SGLT2 Inhibitors in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: A Multicenter Propensity Score-Matched Real-World Study.
Observational study in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNo head-to-head trials have directly compared GLP-1 receptor agonists (GLP‑1 RAs) and SGLT2 inhibitors (SGLT2is) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI).
aimsTo compare short-, mid-, and long-term clinical outcomes of GLP-1 RAs versus SGLT2 inhibitors in adults with AMI undergoing PCI, using a multicenter propensity score-matched real-world cohort from the TriNetX US Collaborative Network.
methodsThis multicenter, retrospective cohort study used de-identified data from the TriNetX US Collaborative Network. Adults with AMI who underwent PCI and initiated either GLP‑1 RAs (n = 7201) or SGLT2is (n = 4252) within 14 days were included. One-to-one greedy nearest-neighbor propensity score matching (caliper 0.1) yielded balanced cohorts across > 50 covariates, resulting in 1752 patients per group. Kaplan-Meier and Cox models assessed mortality, heart failure, hospitalization, recurrent myocardial infarction (RMI), stroke, atrial fibrillation, major adverse cardiovascular events (MACE), acute kidney injury (AKI), and cardiac arrest.
resultsCompared with SGLT2is, GLP-1 RAs were associated with lower 1-year risks of acute heart failure (HR 0.415 [0.343-0.501]), all-cause hospitalization (HR 0.559 [0.495-0.631]), RMI (HR 0.799 [0.710-0.899]), stroke (HR 0.800 [0.667-0.959]), atrial fibrillation (HR 0.804 [0.693-0.932]), MACE (HR 0.788 [0.706-0.881]), and AKI (HR 0.534 [0.444-0.643]). At 30 days, absolute risk reduction was lower with GLP-1 RAs for acute heart failure (7.19% [5.66%-8.72%]) and all-cause hospitalization (16.61% [14.24%-18.98%]). All-cause mortality did not differ at 30 or 90 days but was lower at 1 year (HR 0.700 [0.507-0.967]). Cardiac arrest did not differ significantly.
conclusionsIn this real-world, propensity score-matched study of patients with AMI undergoing PCI, GLP-1 RA initiation linked to lower risk of short- and long-term adverse outcomes than SGLT2i. These are observational findings needing confirmation in randomized trials.
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