Trends in prescriptions of cardioprotective diabetic agents after coronary artery bypass grafting among U.S. veterans

Deo, S. V. , McAllister, D. A. , Al-Kindi, S., Elgudin, Y., Chu, D., Pell, J. and Sattar, N. (2022) Trends in prescriptions of cardioprotective diabetic agents after coronary artery bypass grafting among U.S. veterans. Diabetes Care, 45(12), pp. 3054-3057. (doi: 10.2337/dc22-0570) (PMID:36256925)

Abstract

OBJECTIVE: Patients with type 2 diabetes undergoing coronary artery bypass grafting (CABG) are at risk for cardiovascular events. Sodium–glucose cotransporter 2 receptor inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RA) are effective cardioprotective agents; however, their prescription among CABG patients is uncertain. The aims of this study were 1) to evaluate the overall use of SGLT2i/GLP-1RA after CABG and explore longitudinal trends and 2) to examine patient-related factors associated with the use of SGLT2i or GLP-1RA. RESEARCH DESIGN AND METHODS: We analyzed the nationwide Veterans Affairs (VA) database (2016–2019) to report trends and factors associated with SGLT2i or GLP-1RA prescription after CABG. RESULTS: Among 5,109 patients operated on at 40 different VA medical centers, 525 of 5,109 (10.4%), 352 of 5,109 (6.8%), and 91 of 5,109 (1.8%) were prescribed SGLT2i, GLP-1RA, and both, respectively. A substantial increase in the quarterly SGLT2i prescription rates (1.6% [first quarter of 2016 (2016Q1)], 33% [2019Q4]) was present but was lower for GLP-1RA (0.8% [2016Q1], 11.2% [2019Q4]). SGLT2i use was less likely with preexisting vascular disease (odd ratio [OR] 0.75, 95% CI 0.75, 0.94) or kidney disease (OR 0.72, 95% CI 0.58, 0.88), while GLP-1RA use was associated with obesity (OR 1.91, 95% CI 1.50, 2.46). CONCLUSIONS: The overall utilization of SGLT2i or GLP-1RA drugs in U.S. veterans with type 2 diabetes undergoing CABG is low, with SGLT2i preferred over GLP-1RA.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McAllister, Professor David and Pell, Professor Jill and Sattar, Professor Naveed and Deo, Salil
• Authors: Deo, S. V., McAllister, D. A., Al-Kindi, S., Elgudin, Y., Chu, D., Pell, J., and Sattar, N.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Diabetes Care
• Publisher: American Diabetes Association
• ISSN: 0149-5992
• ISSN (Online): 1935-5548
• Published Online: 18 October 2022
• Copyright Holders: Copyright © 2022 by the American Diabetes Association
• First Published: First published in Diabetes Care 45(12): 3054-3057
• Publisher Policy: Reproduced in accordance with the publisher copyright policy