ArticleReviews in cardiovascular medicine2026
Exploration of the Effects of SGLT-2 Inhibitors and GLP-1 Receptor Agonists on Coronary Inflammation in Type 2 Diabetes Patients Based on the Peri-Coronary Fat Attenuation Index.
Article in Reviews in cardiovascular medicine, 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
Background: The peri-coronary fat attenuation index (FAI) is a novel imaging biomarker of inflammation. This study aimed to investigate the association between combination therapy with sodium-glucose transporter 2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) and coronary artery inflammation, as assessed by the peri-coronary FAI, in patients with type 2 diabetes mellitus (T2DM). Methods: This retrospective analysis included 292 patients with T2DM who underwent coronary computed tomography angiography (CCTA) at Hebei General Hospital. Patients were divided into three groups: (1) non-SGLT-2i/GLP-1RA users (non-users, n = 125): Patients not receiving SGLT-2i or GLP-1RA therapy; (2) SGLT-2i/GLP-1RA monotherapy group (mono-tx, n = 124): Patients treated with either SGLT-2i or GLP-1RA alone; (3) SGLT-2i + GLP-1RA combination therapy group (combo-tx, n = 43): Patients receiving concurrent SGLT-2i and GLP-1RA therapy. Clinical parameters, laboratory biomarkers, and the peri-coronary FAI of patients were collected and comparatively analyzed among the three groups. Finally, multivariate linear regression models were constructed to elucidate the independent association between combined GLP-1RA and SGLT-2i therapy and the peri-coronary FAI. Results: One-way analysis of variance (ANOVA) revealed significant differences in the peri-coronary FAI among the three therapy groups. Specifically, compared with the non-user group, the combo-tx group had significantly lower peri-coronary FAI values in the left circumflex artery (LCX) and left anterior descending artery (LAD). Compared with the mono-tx group, the combo-tx group also had a significantly lower LCX FAI. Multivariate regression analysis further confirmed that combination therapy was independently associated with a lower FAI in the LAD, LCX, and right coronary artery (RCA). Subgroup analysis revealed a significant interaction by sex in the association between treatment regimen and LCX FAI. Conclusion: The combined use of SGLT-2 inhibitors and GLP-1RAs may be associated with a decrease in the peri-coronary FAI in patients with T2DM, suggesting a potential role in reducing coronary inflammation. Thus, this combination therapy might offer advantages over monotherapy.
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