Low utilization of GLP-1RAs and SGLT2i in high-risk
cardiovascular patients with diabetes: nationwide insights from
myocardial Infarction and stroke survivors

a 2025

Low utilization of GLP-1RAs and SGLT2i in high-risk cardiovascular patients with diabetes: nationwide insights from myocardial Infarction and stroke survivors

ŠEDOVÁ, Petra; Petr KALA; P. OSTADAL; Jiří JARKOVSKÝ; Simona LITTNEROVÁ et al.

Základní údaje

Originální název

Low utilization of GLP-1RAs and SGLT2i in high-risk cardiovascular patients with diabetes: nationwide insights from myocardial Infarction and stroke survivors

Autoři

ŠEDOVÁ, Petra; Petr KALA; P. OSTADAL; Jiří JARKOVSKÝ ; Simona LITTNEROVÁ; Robert MIKULÍK; A. TOMEK; A. TICHOPAD; V. K. SOMERS; R. D. BROWN a M. VRABLIK

Vydání

ESC Congress 2025 together with World Congress of Cardiology Friday, 29 August - Monday, 01 September 2025 Madrid, 2025

Další údaje

Jazyk

angličtina

Typ výsledku

Konferenční abstrakt

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Označené pro přenos do RIV

Ano

Organizační jednotka

Lékařská fakulta

DOI

https://doi.org/10.1093/eurheartj/ehaf784.3655

UT WoS

001676058100001

Klíčová slova anglicky

GLP-1 receptor agonists; SGLT2 inhibitors; cardiovascular risk; diabetes management; treatment utilization

Štítky

rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 24. 3. 2026 10:00, Mgr. Tereza Miškechová

Anotace

V originále

Background Cardiovascular disease (CVD) is the leading cause of death in patients with type 2 diabetes mellitus (T2DM). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated cardiovascular (CV) benefits and are recommended for T2DM patients with atherosclerotic CVD (ASCVD). However, real-world data on their adoption in high-risk populations, particularly myocardial infarction (MI) and stroke survivors, remain limited. Purpose To assess real-world utilization of GLP-1RAs and SGLT2i among T2DM patients with ASCVD focusing on trends, disparities by age, sex, and region from 2015 to 2023. Methods A nationwide cohort study using data from the National Registry of Reimbursed Health Services (2015–2023), covering all reimbursed health services in the Czech Republic. Patients with nonfatal MI (ICD-10: I21, I22) or stroke (I63, I64) and confirmed T2DM were included. Prescriptions were identified at the event or within 12 months post-event. Utilization trends were analyzed, and logistic regression was used to determine predictors of medication use. Results Among 116,218 MI patients (median age:68 years, 33.5% women), 53,128 (46%) had T2DM (median age:71 years, 37% women). Within 12 months post-MI, 2.1% received GLP-1RAs and 10.6% received SGLT2i, with increasing trends from 0.3% (2015) to 4.8% (2023) (GLP-1RAs) and 0.4% (2015) to 34.8% (2023) (SGLT2i). Women were less likely to receive SGLT2i (aOR: 0.70 [95%CI:0.65–0.74]), while no significant difference was observed for GLP-1RAs (aOR:0.98 [95%CI:0.86–1.12]). Older patients (>70 years) had lower odds of receiving GLP-1RAs (aOR:0.31 [95%CI:0.27–0.36]) and SGLT2i (aOR:0.53 [95%CI:0.50–0.56]). Prescription rates were highest in Prague (3.1% GLP-1RAs; 13.5% SGLT2i) and lowest in the Moravian-Silesian Region (1.4% GLP-1RAs; 8.8% SGLT2i). Among 164,729 stroke patients (median age:73 years, 49% women), 78,562 (48%) had T2DM (median age:75 years, 50% women). Within 12 months post-stroke, 1.2% received GLP-1RAs and 3.7% received SGLT2i, with increasing trends from 0.2% (2015) to 2.8% (2023) (GLP-1RAs) and 0.1% (2015) to 10.4% (2023) (SGLT2i). Women were less likely to receive GLP-1RAs (aOR:0.82 [95%CI:0.72–0.95]) and SGLT2i (aOR:0.57 [95%CI:0.52–0.62]). Older patients (>70 years) had lower odds of receiving GLP-1RAs (aOR:0.31 [95%CI:0.27–0.36]) and SGLT2i (aOR:0.40 [95%CI:0.37–0.44]). Regional disparities were notable, with prescription rates varying from 0.8–2.1% (GLP-1RAs) and 2.4–5.2% (SGLT2i). Conclusions Prescribing rates for GLP-1RAs and SGLT2i have increased over the past eight years but remain low, even among MI and stroke survivors. Women, older patients, and those in lower-income regions are significantly less likely to receive these therapies. Targeted interventions are needed to improve secondary prevention in high-risk diabetic populations and to address these disparities.

Návaznosti

NW24-09-00215, projekt VaV

Název: Analýza velkých dat pro záchranu životů pacientů s akutním infarktem myokardu a cévní mozkovou příhodou v České republice (MISA-BID Myocardial Infarction and Stroke Big Data Analysis)

Investor: Ministerstvo zdravotnictví ČR, Analýza velkých dat pro záchranu životů pacientů s akutním infarktem myokardu a cévní mozkovou příhodou v České republice (MISA-BID Myocardial Infarction and Stroke Big Data Analysis), Podprogram 1 - standardní

Citovat

ŠEDOVÁ, Petra; Petr KALA; P. OSTADAL; Jiří JARKOVSKÝ; Simona LITTNEROVÁ; Robert MIKULÍK; A. TOMEK; A. TICHOPAD; V. K. SOMERS; R. D. BROWN a M. VRABLIK. Low utilization of GLP-1RAs and SGLT2i in high-risk cardiovascular patients with diabetes: nationwide insights from myocardial Infarction and stroke survivors. In ESC Congress 2025 together with World Congress of Cardiology Friday, 29 August - Monday, 01 September 2025 Madrid. 2025. Dostupné z: https://doi.org/10.1093/eurheartj/ehaf784.3655.

@proceedings{2544937,
   author = {Šedová, Petra and Kala, Petr and Ostadal, P. and Jarkovský, Jiří and Littnerová, Simona and Mikulík, Robert and Tomek, A. and Tichopad, A. and Somers, V. K. and Brown, R. D. and Vrablik, M.},
   booktitle = {ESC Congress 2025 together with World Congress of Cardiology Friday, 29 August - Monday, 01 September 2025 Madrid},
   doi = {https://doi.org/10.1093/eurheartj/ehaf784.3655},
   keywords = {GLP-1 receptor agonists; SGLT2 inhibitors; cardiovascular risk; diabetes management; treatment utilization},
   language = {eng},
   title = {Low utilization of GLP-1RAs and SGLT2i in high-risk cardiovascular patients with diabetes: nationwide insights from myocardial Infarction and stroke survivors},
   url = {https://academic.oup.com/eurheartj/article/46/Supplement_1/ehaf784.3655/8311509},
   year = {2025}
}

TY  - CONF
ID  - 2544937
AU  - Šedová, Petra - Kala, Petr - Ostadal, P. - Jarkovský, Jiří - Littnerová, Simona - Mikulík, Robert - Tomek, A. - Tichopad, A. - Somers, V. K. - Brown, R. D. - Vrablik, M.
PY  - 2025
TI  - Low utilization of GLP-1RAs and SGLT2i in high-risk cardiovascular patients with diabetes: nationwide insights from myocardial Infarction and stroke survivors
KW  - GLP-1 receptor agonists
KW  - SGLT2 inhibitors
KW  - cardiovascular risk
KW  - diabetes management
KW  - treatment utilization
UR  - https://academic.oup.com/eurheartj/article/46/Supplement_1/ehaf784.3655/8311509
N2  - Background Cardiovascular disease (CVD) is the leading cause of death in patients with type 2 diabetes mellitus (T2DM). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated cardiovascular (CV) benefits and are recommended for T2DM patients with atherosclerotic CVD (ASCVD). However, real-world data on their adoption in high-risk populations, particularly myocardial infarction (MI) and stroke survivors, remain limited. Purpose To assess real-world utilization of GLP-1RAs and SGLT2i among T2DM patients with ASCVD focusing on trends, disparities by age, sex, and region from 2015 to 2023. Methods A nationwide cohort study using data from the National Registry of Reimbursed Health Services (2015–2023), covering all reimbursed health services in the Czech Republic. Patients with nonfatal MI (ICD-10: I21, I22) or stroke (I63, I64) and confirmed T2DM were included. Prescriptions were identified at the event or within 12 months post-event. Utilization trends were analyzed, and logistic regression was used to determine predictors of medication use. Results Among 116,218 MI patients (median age:68 years, 33.5% women), 53,128 (46%) had T2DM (median age:71 years, 37% women). Within 12 months post-MI, 2.1% received GLP-1RAs and 10.6% received SGLT2i, with increasing trends from 0.3% (2015) to 4.8% (2023) (GLP-1RAs) and 0.4% (2015) to 34.8% (2023) (SGLT2i). Women were less likely to receive SGLT2i (aOR: 0.70 [95%CI:0.65–0.74]), while no significant difference was observed for GLP-1RAs (aOR:0.98 [95%CI:0.86–1.12]). Older patients (>70 years) had lower odds of receiving GLP-1RAs (aOR:0.31 [95%CI:0.27–0.36]) and SGLT2i (aOR:0.53 [95%CI:0.50–0.56]). Prescription rates were highest in Prague (3.1% GLP-1RAs; 13.5% SGLT2i) and lowest in the Moravian-Silesian Region (1.4% GLP-1RAs; 8.8% SGLT2i). Among 164,729 stroke patients (median age:73 years, 49% women), 78,562 (48%) had T2DM (median age:75 years, 50% women). Within 12 months post-stroke, 1.2% received GLP-1RAs and 3.7% received SGLT2i, with increasing trends from 0.2% (2015) to 2.8% (2023) (GLP-1RAs) and 0.1% (2015) to 10.4% (2023) (SGLT2i). Women were less likely to receive GLP-1RAs (aOR:0.82 [95%CI:0.72–0.95]) and SGLT2i (aOR:0.57 [95%CI:0.52–0.62]). Older patients (>70 years) had lower odds of receiving GLP-1RAs (aOR:0.31 [95%CI:0.27–0.36]) and SGLT2i (aOR:0.40 [95%CI:0.37–0.44]). Regional disparities were notable, with prescription rates varying from 0.8–2.1% (GLP-1RAs) and 2.4–5.2% (SGLT2i). Conclusions Prescribing rates for GLP-1RAs and SGLT2i have increased over the past eight years but remain low, even among MI and stroke survivors. Women, older patients, and those in lower-income regions are significantly less likely to receive these therapies. Targeted interventions are needed to improve secondary prevention in high-risk diabetic populations and to address these disparities.
ER  -

ŠEDOVÁ, Petra; Petr KALA; P. OSTADAL; Jiří JARKOVSKÝ; Simona LITTNEROVÁ; Robert MIKULÍK; A. TOMEK; A. TICHOPAD; V. K. SOMERS; R. D. BROWN a M. VRABLIK. Low utilization of GLP-1RAs and SGLT2i in high-risk cardiovascular patients with diabetes: nationwide insights from myocardial Infarction and stroke survivors. In \textit{ESC Congress 2025 together with World Congress of Cardiology Friday, 29 August - Monday, 01 September 2025 Madrid}. 2025. Dostupné z: https://doi.org/10.1093/eurheartj/ehaf784.3655.

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