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Trends in prescriptions of cardio-protective diabetic agents after coronary artery bypass grafting among US Veterans

Version 2 2022-11-28, 16:56

Version 1 2022-10-18, 19:35

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posted on 2022-11-28, 16:56 authored by Salil V Deo, David A McAllister, Sadeer Al-Kindi, Yakov Elgudin, Danny Chu, Jill Pell, Naveed Sattar

Introduction: Patients with type 2 diabetes mellitus (T2DM) undergoing coronary artery bypass grafting (CABG) are at risk of cardiovascular events. SGLT2i and GLP-1RA are effective cardio-protective agents, however, their prescription among CABG patients is uncertain.

Methods: We analyzed the nationwide Veteran Affairs database (2016 – 2019) to report trends and factors associated with SGLT2i or GLP1RA prescription after CABG.

Results: Among 5,109 patients operated at 40 different VA medical centers, 525/5109 (10.4%), 352/5109 (6.8%) and 91/5109 (1.8%) were prescribed SGLT2i, GLP-1RA and both respectively. Substantial increase in the quarterly SGLPT2i prescription rates (1.6% (2016Q1), 33% (2019Q4)) was present; less so for GLP-1RA (0.8% (2016Q1), 11.2% (2019Q4)). SGLT2i use was less likely with pre-existing vascular disease (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]).

Conclusion: The overall utilization of SGLT2i or GLP-1RA drugs in US Veterans with T2DM undergoing CABG is low, with SGLT2i preferred over GLP-1RA.