Comparative cardiovascular outcomes of semaglutide to dulaglutide in patients with type 2 diabetes

Abstract Type 2 diabetes significantly increases cardiovascular risk. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) reduce major adverse cardiovascular events, heart failure hospitalizations, and death. However, the comparison among GLP-1 RAs on cardiovascular outcomes is limited. We compared...

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Main Authors: Takefumi Kishimori, Takao Kato, Atsuyuki Wada, Akira Tani, Ryosuke Yamaji, Jumpei Koike, Yoshihiro Iwasaki, Takehiro Matsumoto, Takafumi Yagi, Masaharu Okada
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-06245-w
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author Takefumi Kishimori
Takao Kato
Atsuyuki Wada
Akira Tani
Ryosuke Yamaji
Jumpei Koike
Yoshihiro Iwasaki
Takehiro Matsumoto
Takafumi Yagi
Masaharu Okada
author_facet Takefumi Kishimori
Takao Kato
Atsuyuki Wada
Akira Tani
Ryosuke Yamaji
Jumpei Koike
Yoshihiro Iwasaki
Takehiro Matsumoto
Takafumi Yagi
Masaharu Okada
author_sort Takefumi Kishimori
collection DOAJ
description Abstract Type 2 diabetes significantly increases cardiovascular risk. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) reduce major adverse cardiovascular events, heart failure hospitalizations, and death. However, the comparison among GLP-1 RAs on cardiovascular outcomes is limited. We compared all-cause death and cardiovascular events in patients using semaglutide or dulaglutide in patients with type 2 diabetes. This retrospective observational study used the TriNetX database of deidentified electronic medical records from January 1, 2018, to December 31, 2020. We identified 4,691,652 patients with type 2 diabetes, among whom 231,075 initiated semaglutide and 189,103 initiated dulaglutide. After propensity score matching, 171,105 patients were included in each group. The primary outcome measure was all-cause death during the 3-year follow-up period.; secondary outcomes were acute myocardial infarction, stroke, and acute heart failure.Over 3 years, the risk for all-cause death in patients who received semaglutide relative to those who received dulaglutide was significantly lower (4.2% vs. 5.6%, p < 0.001; hazard ratio [HR] 0.75; 95% confidence interval [CI] 0.72–0.78). Similarly, patients who received semaglutide were less likely to have acute myocardial infarction (5.2% vs. 5.6%; HR, 0.94; 95% CI, 0.91–0.97; p < 0.001), stroke (5.8% vs. 6.4%; HR, 0.90; 95% CI, 0.87–0.93; p < 0.001), and acute heart failure (5.3% vs. 6.1%; HR, 0.88; 95% CI, 0.85–0.91; p < 0.001).In this multicenter, retrospective, observational study, semaglutide was associated with lower 3-year risks of all-cause death, acute myocardial infarction, stroke, and acute heart failure compared with dulaglutide in patients with type 2 diabetes.
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spelling doaj-art-9bcfe815cd4f4d52b9b8352cbfc5d75f2025-08-20T03:03:40ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-06245-wComparative cardiovascular outcomes of semaglutide to dulaglutide in patients with type 2 diabetesTakefumi Kishimori0Takao Kato1Atsuyuki Wada2Akira Tani3Ryosuke Yamaji4Jumpei Koike5Yoshihiro Iwasaki6Takehiro Matsumoto7Takafumi Yagi8Masaharu Okada9Department of Cardiovascular Medicine, Omi Medical CenterDepartment of Cardiovascular Medicine, Kyoto University Graduate School of MedicineDepartment of Cardiovascular Medicine, Omi Medical CenterDepartment of Cardiovascular Medicine, Omi Medical CenterDepartment of Cardiovascular Medicine, Omi Medical CenterDepartment of Cardiovascular Medicine, Omi Medical CenterDepartment of Cardiovascular Medicine, Omi Medical CenterDepartment of Cardiovascular Medicine, Omi Medical CenterDepartment of Cardiovascular Medicine, Omi Medical CenterDepartment of Cardiovascular Medicine, Omi Medical CenterAbstract Type 2 diabetes significantly increases cardiovascular risk. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) reduce major adverse cardiovascular events, heart failure hospitalizations, and death. However, the comparison among GLP-1 RAs on cardiovascular outcomes is limited. We compared all-cause death and cardiovascular events in patients using semaglutide or dulaglutide in patients with type 2 diabetes. This retrospective observational study used the TriNetX database of deidentified electronic medical records from January 1, 2018, to December 31, 2020. We identified 4,691,652 patients with type 2 diabetes, among whom 231,075 initiated semaglutide and 189,103 initiated dulaglutide. After propensity score matching, 171,105 patients were included in each group. The primary outcome measure was all-cause death during the 3-year follow-up period.; secondary outcomes were acute myocardial infarction, stroke, and acute heart failure.Over 3 years, the risk for all-cause death in patients who received semaglutide relative to those who received dulaglutide was significantly lower (4.2% vs. 5.6%, p < 0.001; hazard ratio [HR] 0.75; 95% confidence interval [CI] 0.72–0.78). Similarly, patients who received semaglutide were less likely to have acute myocardial infarction (5.2% vs. 5.6%; HR, 0.94; 95% CI, 0.91–0.97; p < 0.001), stroke (5.8% vs. 6.4%; HR, 0.90; 95% CI, 0.87–0.93; p < 0.001), and acute heart failure (5.3% vs. 6.1%; HR, 0.88; 95% CI, 0.85–0.91; p < 0.001).In this multicenter, retrospective, observational study, semaglutide was associated with lower 3-year risks of all-cause death, acute myocardial infarction, stroke, and acute heart failure compared with dulaglutide in patients with type 2 diabetes.https://doi.org/10.1038/s41598-025-06245-w
spellingShingle Takefumi Kishimori
Takao Kato
Atsuyuki Wada
Akira Tani
Ryosuke Yamaji
Jumpei Koike
Yoshihiro Iwasaki
Takehiro Matsumoto
Takafumi Yagi
Masaharu Okada
Comparative cardiovascular outcomes of semaglutide to dulaglutide in patients with type 2 diabetes
Scientific Reports
title Comparative cardiovascular outcomes of semaglutide to dulaglutide in patients with type 2 diabetes
title_full Comparative cardiovascular outcomes of semaglutide to dulaglutide in patients with type 2 diabetes
title_fullStr Comparative cardiovascular outcomes of semaglutide to dulaglutide in patients with type 2 diabetes
title_full_unstemmed Comparative cardiovascular outcomes of semaglutide to dulaglutide in patients with type 2 diabetes
title_short Comparative cardiovascular outcomes of semaglutide to dulaglutide in patients with type 2 diabetes
title_sort comparative cardiovascular outcomes of semaglutide to dulaglutide in patients with type 2 diabetes
url https://doi.org/10.1038/s41598-025-06245-w
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