Retrospective evaluation of cardiovascular eventsdevelopment rates in diabetes mellitus diagnosed patients using SGLT-2 inhibitor or GLP-1 analogue

Cardiovascular diseases and related deaths are higher in patients with type 2 diabetes than non-diabetic people. There are recent large-scale studies on the cardiac effects of SGLT-2 inhibitors (empagliflozin, dapagliflozin etc.) and GLP-1 analogues (exenatide etc.) with positive results. Based on these studies, we evaluated patients who receive treatments of empagliflozin, dapagliflozin and exenatide in our faculty, from a cardiovascular point of view. As the control group, we chose to engage the patients who are on DPP-4 inhibitor (linagliptin etc.), which is known to be cardiacly neutral. We conducted our study with 400 patients in total, 100 patients in each treatment group (linagliptin, exenatide, dapagliflozin, empagliflozin) who have been receiving treatment for at least twelve months. We evaluated myocardial infarction (MI), cerebrovascular event (CVE), death due to cardiac causes, major cardiovascular event (MACE: MI, CVE and cardiac death), hospitalization due to heart failure, unstable angina/acute coronary syndrome (ACS), peripheral artery disease and all-cause deaths. In our patients taking linagliptin, MI was 1%, CVE was 1%, MACE was 2%, unstable angina/ACS was 2%, hospitalization due to heart failure was 2% and all-cause death was 4%. In our patients taking exenatide, MACE was 0%, hospitalization due to heart failure was 1%, unstable angina/ACS was 5% and all-cause death was 0%. In our patients taking dapagliflozin, MACE was 0%, hospitalization due to heart failure was 2%, and all-cause death was 1%. In our patients taking empagliflozin, MACE was 2%, MI was 1%, CVE was 1%, hospitalization due to heart failure was %1 and all-cause death was %1. When the total number of all cardiovascular pathologies are considered, they appear as 10% in the linagliptin group, 6% in the exenatide group, 4% in the dapagliflozin group, and 6% in the empagliflozin group. Although there is a decrease in the rate of cardiac pathologies and mortality in the exenatide, dapagliflozin, empagliflozin treatment groups compared to the linagliptin group, it was not statistically significant. When comparing patients who had no previous cardiac pathology but are known to have multiple risks, it was found that the total cardiac pathology rates significantly decreased statistically in the exenatide, dapagliflozin and empagliflozin group compared to the linagliptin group. These results show that the exenatide, dapagliflozin and empagliflozin treatments are beneficial for primary protection of our diabetic patients from cardiac pathologies.