Effects of GLP-1 agonists on 10-year cardiovascular risk reduction in primary prevention: A 44-week open label prospective study.

AIMS: Patients with Type 2 diabetes mellitus face elevated cardiovascular risk. We assessed the effect of GLP-1 receptor agonists on 10-year CVR in a primary prevention cohort.

METHODS

In this 44-week prospective, non-randomized study, 135 patients with type 2 diabetes mellitus and obesity were included across 13 healthcare centers. The primary endpoint was the change in 10-year cardiovascular risk, estimated using the AHA ASCVD Risk Estimator Plus tool at baseline and week 44. Secondary endpoints included weight loss, HbA1c, fasting plasma glucose, and lipid profiles. Patients received subcutaneous semaglutide, oral semaglutide, dulaglutide, or other GLP-1RAs.

RESULTS

In the primary prevention cohort (n = 105), mean 10-year CVR decreased by 3.28 percentage points, a relative reduction of 13.45 % (p < 0.001). Subcutaneous semaglutide showed the greatest weight loss (-8.1 kg), followed by oral semaglutide (-6.5 kg) and dulaglutide (-5.6 kg). HbA1c improved from 8.1 % to 6.6 %, and fasting plasma glucose decreased by 45.8 mg/dL (both p < 0.001).

CONCLUSIONS

GLP-1 receptor agonists reduce 10-year cardiovascular risk in primary prevention and improve metabolic control. Findings support early use in high-risk people with type 2 diabetes.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT05136287.