CHICAGO — CT angiography (CCTA) shows that GLP-1 receptor agonists curb the advancement of heart plaques in patients with type 2 diabetes, according to a study highlighted at the RSNA meeting.
The results could be good news for people with diabetes, as they tend to be at higher risk of cardiovascular disease.
“[Our] study demonstrates that GLP-1 receptor agonists have a superior effect in slowing the progression of coronary atherosclerotic plaques at the vascular level in type 2 diabetes patients,” wrote a team led by Junyan Zhang, PhD, of Sichuan Hospital in Chengdu, China.
It has been unclear how noninsulin glucose-lowering therapies affect the progression of heart plaques in these patients, Zhang and colleagues noted. To address the knowledge gap, the researchers used CCTA to assess the impact of five noninsulin diabetes therapies via a study that included data regarding 3,520 vessels from serial CCTA images of diabetic patients taken from the TOuCh for CATheter Ablation (TOCCATA) study.
Patients were categorized into five treatment groups: metformin (1,271 vessels), DPP-4 inhibitors (316 vessels), GLP-1 receptor agonists (GLP-1 RAs, 308 vessels), SGLT-2 inhibitors (SGLT2i, 877 vessels), and thiazolidinediones (TZDs, 288 vessels).
Overall, the investigators reported the following:
- At the vascular level, the GLP-1 RAs group showed a significant reduction in the risk of stenosis progression compared to the metformin group (adjusted hazard ratio [HR], 0.68 [with one as reference], p = 0.024).
- The DPP-4 inhibitors group showed an increased trend in the risk of stenosis progression (adjusted HR 1.31, p = 0.039).
- There were no significant differences in the SGLT-2 inhibitors and the TZDs groups (adjusted HR 0.99 [p = 0.9] and 1.28 [p = 0.086], respectively).
“The findings emphasize the importance of selecting treatment regimens based on atherosclerotic burden and provide a basis for radiologists to guide personalized treatment strategies for T2DM patients using CCTA,” Zhang and colleagues concluded.