King Aaron, Tan Xi, Dhopeshwarkar Neil, Bohn Rhonda, Dea Katherine, Leonard Charles E, de Havenon Adam
Baptist Health System Physicians Network, MedFirst Primary Care - Quarry, 430 W Sunset Rd Suite, San Antonio, TX 78209, USA.
Novo Nordisk Inc., 800 Scudders Mill Rd, Plainsboro, NJ 08536, USA.
Am J Prev Cardiol. 2025 Jan 8;21:100922. doi: 10.1016/j.ajpc.2024.100922. eCollection 2025 Mar.
Limited data exist on the cardiovascular effectiveness of once-weekly (OW) glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in real-world practice.
We assessed the OW GLP-1 RA effects on vascular risk factors in adults with type 2 diabetes and atherosclerotic cardiovascular disease using data from a large-scale US electronic health record database (index date = first prescription of OW GLP-1 RA). Exploratory analyses were performed on patients newly initiating OW GLP-1 RAs with semaglutide, OW GLP-1 RAs without semaglutide, and semaglutide. Changes in vascular risk factors were evaluated by comparing mean measures between the 12-month pre- and post-index periods. Analyses were conducted for all three cohorts and subpopulations including stratified by tercile of baseline vascular risk factor value.
In the final cohorts ([1] OW GLP-1 RA including semaglutide: = 20,084; [2] OW GLP-1 RA excluding semaglutide: = 16,894; [3] semaglutide: = 3,435), significant mean reductions ( < 0.001) were observed from baseline to post-index in hemoglobin A1c (%, [1] -1.1; [2] -1.1; [3] -1.2), low-density lipoprotein cholesterol (mg/dL, [1] -6.4; [2] -6.4; [3] -6.9), total cholesterol (mg/dL, [1] -11.0; [2] -11.1; [3] -10.7), triglycerides (mg/dL, [1] -31.8; [2] -31.4; [3] -33.1), systolic blood pressure (mmHg, [1] -1.5; [2] -1.2; [3] -3.1), body weight (kg, [1] -2.7; [2] -2.4; [3] -4.3) and body mass index (kg/m; [1] -0.9; [2] -0.8; [3] -1.4). Largest reductions were observed in the top tercile.
Our data suggest GLP-1 RAs are associated with significant reductions in key vascular risk factors in real-world practice.
关于每周一次（OW）胰高血糖素样肽-1受体激动剂（GLP-1 RAs）在实际临床中的心血管有效性的数据有限。
我们使用美国一个大规模电子健康记录数据库的数据（索引日期=首次开具OW GLP-1 RA处方），评估OW GLP-1 RA对患有2型糖尿病和动脉粥样硬化性心血管疾病的成年人血管危险因素的影响。对新开始使用司美格鲁肽的OW GLP-1 RAs、不使用司美格鲁肽的OW GLP-1 RAs以及司美格鲁肽的患者进行了探索性分析。通过比较索引前和索引后12个月期间的平均测量值来评估血管危险因素的变化。对所有三个队列和亚组进行了分析，包括按基线血管危险因素值的三分位数分层。
在最终队列中（[1]包括司美格鲁肽的OW GLP-1 RA：n = 20,084；[2]不包括司美格鲁肽的OW GLP-1 RA：n = 16,894；[3]司美格鲁肽：n = 3,435），从基线到索引后观察到糖化血红蛋白（%，[1]-1.1；[2]-1.1；[3]-1.2）、低密度脂蛋白胆固醇（mg/dL，[1]-6.4；[2]-6.4；[3]-6.9）、总胆固醇（mg/dL，[1]-11.0；[2]-11.1；[3]-10.7）、甘油三酯（mg/dL，[1]-31.8；[2]-31.4；[3]-33.1）、收缩压（mmHg，[1]-1.5；[2]-1.2；[3]-3.1）、体重（kg，[1]-2.7；[2]-2.4；[3]-4.3）和体重指数（kg/m²，[1]-0.9；[2]-0.8；[3]-1.4）均有显著的平均降低（P < 0.001）。在最高三分位数中观察到最大降幅。
我们的数据表明，在实际临床中，GLP-1 RAs与关键血管危险因素的显著降低有关。
