Karthikeyan Hridhay, Fan Wenjun, Wong Nathan D
Mary and Steve Wen Cardiovascular Division, School of Medicine, University of California, Irvine, CA, USA.
Center for Global Cardiometabolic Health and Nutrition, University of California, Irvine, CA, USA.
Diab Vasc Dis Res. 2025 Sep-Oct;22(5):14791641251376551. doi: 10.1177/14791641251376551. Epub 2025 Sep 4.
BackgroundThe SUSTAIN-6 trial showed the cardiovascular disease (CVD) benefits of semaglutide among patients with type 2 diabetes mellitus (T2DM). We estimated the US population eligibility and preventable CVD events from semaglutide.MethodsUS adults with T2DM were selected from the National Health and Nutrition Examination Survey 2011-2020 based on SUSTAIN-6 eligibility criteria. We estimated composite and secondary CVD events from SUSTAIN-6 treated and placebo published event rates multiplied by the weighted US eligible population, the difference being the number of preventable events which was then divided by 2.1 years to provide annualized estimates.ResultsAmong 4755 (projected to 33.6 million [M]) adults with T2DM, 1132 (6.9 million) fit SUSTAIN-6 criteria. Compared to SUSTAIN-6, our sample more likely had female and black patients, shorter diabetes duration, and was less likely with prior CVD. We estimated 75,681 primary outcome CVD events, 128,329 expanded composite CVD events, 72,390 combined nonfatal MI, nonfatal stroke, and all-cause deaths, 36,195 non-fatal stroke events, 85,552 revascularizations, and 75,681 cases of nephropathy could be prevented annually if eligible T2DM subjects were on semaglutide.ConclusionSemaglutide may prevent over 75,000 CVD events annually if provided to eligible T2DM US adults. Efforts to improve use of these therapies are needed.
背景
SUSTAIN-6试验显示了司美格鲁肽在2型糖尿病(T2DM)患者中对心血管疾病(CVD)的益处。我们估算了美国符合使用司美格鲁肽条件的人群数量以及可预防的CVD事件。
方法
根据SUSTAIN-6的入选标准,从2011 - 2020年美国国家健康和营养检查调查中选取患有T2DM的美国成年人。我们根据SUSTAIN-6中治疗组和安慰剂组公布的事件发生率,乘以加权后的美国符合条件人群数量,估算复合和继发性CVD事件,二者之差即为可预防事件的数量,然后将其除以2.1年以得出年化估算值。
结果
在4755名(预计为3360万)患有T2DM的成年人中,1132名(690万)符合SUSTAIN-6标准。与SUSTAIN-6相比,我们的样本中女性和黑人患者更多,糖尿病病程更短,且既往有CVD的可能性更小。我们估计,如果符合条件的T2DM受试者使用司美格鲁肽,每年可预防75681例主要结局CVD事件、128329例扩展复合CVD事件、72390例非致命性心肌梗死、非致命性中风和全因死亡合并事件、36195例非致命性中风事件、85552例血运重建以及75681例肾病病例。
结论
如果为符合条件的美国成年T2DM患者提供司美格鲁肽,每年可能预防超过75000例CVD事件。需要努力提高这些疗法的使用。