Diabetes is a prime risk factor for cardiovascular disease (CVD) is already established. However, the risk of CVD due to the use of glucose-lowering medications is not well-documented. This study aims to evaluate the association between glucose-lowering medicines and the risk of cardiovascular outcomes.

This umbrella review and meta-analysis included a total of 232 studies and randomized controlled trials assessing the cardiovascular safety of glucose-lowering medications. The most common cardiovascular events, including stroke, myocardial infarction, heart failure, unstable angina, atrial fibrillation, and cardiovascular death, were examined. The primary outcome of the study was the relative risk of CVD.

Of 232 meta-analyses included in the study, six risk and 38 protective sessions were discovered. Glimepiride, rosiglitazone, and pioglitazone were associated with the highest risk of heart failure, myocardial infarction, and stroke. On the other hand, the following associations decreased the risk of adverse cardiovascular outcomes: glucagon-like peptide-1 receptor agonists, albiglutide, dulaglutide, exenatide, liraglutide, semaglutide, sodium-glucose co-transporter-2 inhibitors, canagliflozin, dapagliflozin, empagliflozin, and pioglitazone. For high-risk glucose-lowering medications, the relative risk was 1.0-4.0, as compared with 0.4-1.0 for low-risk medications.

The research concluded that glucose-lowering medications had both high-risk and low-risk associations with cardiovascular disease. Physicians should, therefore, consider the cardiovascular outcomes of glucose-lowering prescription drugs.

Ref: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30422-X/fulltext