{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:20:06Z","timestamp":1791908406229,"version":"4.3.4"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Diabetol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Sodium-glucose cotransporter 2 inhibitors (SGLT2-I) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have been shown to reduce cardiovascular risk and mortality in patients with type 2 diabetes mellitus (T2D), yet remain underutilized in clinical practice. This study aimed to evaluate real-world treatment patterns and associated mortality outcomes among patients with T2D and established atherosclerotic cardiovascular disease (ASCVD).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>The CARdiovascular and DIABetes (CARDIAB) cohort included 138,397 patients with T2D and ASCVD. Patients were categorized into four treatment groups: (i) both SGLT2-I and GLP-1RA, (ii) SGLT2-I only, (iii) GLP-1RA only, and (iv) neither medication. The primary outcome was all-cause mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of the 138,397 patients, 57% received neither SGLT2-I nor GLP-1RA, 17% received both, 20% received SGLT2-I only, and 6% received GLP-1RA only. Female sex, older age, non-coronary ASCVD, and absence of follow-up in specialized cardiology or diabetes clinics were associated with lower treatment rates. Compared to those receiving neither medication, all-cause mortality was significantly lower among patients treated with SGLT2-I only (HR 0.28, 95% CI 0.27\u20130.29), GLP-1RA only (HR 0.39, 95% CI 0.37\u20130.40) and both agents (HR 0.17, 95% CI 0.16\u20130.18). This association remained significant following a multivariate analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>In patients with T2D and ASCVD, treatment with SGLT2-I and GLP-1RA, especially in combination, is associated with a substantial reduction in mortality. These findings highlight significant gaps in implementation and the urgent need to optimize use of evidence-based therapies in this high-risk population.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12933-025-02874-7","type":"journal-article","created":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T18:33:25Z","timestamp":1756665205000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["SGLT2 inhibitors and GLP-1 receptor agonists: impact on mortality in diabetic patients with cardiovascular disease"],"prefix":"10.1186","volume":"24","author":[{"given":"Ziad","family":"Arow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzipi","family":"Hornik-Lurie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranin","family":"Hilu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ela","family":"Giladi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Arnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Vaknin-Assa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abid","family":"Assali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Pereg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"For the CARDIAB research group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,31]]},"reference":[{"key":"2874_CR1","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1056\/NEJMc1706292","volume":"377","author":"A Rawshani","year":"2017","unstructured":"Rawshani A, Rawshani A, Gudbj\u00f6rnsdottir S. Mortality and cardiovascular disease in type 1 and type 2 diabetes. N Engl J Med. 2017;377:300\u20131.","journal-title":"N Engl J Med"},{"key":"2874_CR2","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s11886-019-1133-9","volume":"21","author":"T Htay","year":"2019","unstructured":"Htay T, Soe K, Lopez-Perez A, Doan AH, Romagosa MA, Aung K. Mortality and cardiovascular disease in type 1 and type 2 diabetes. 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In line with Ministry of Health regulations, written informed consent was not required, as data were anonymized and collected retrospectively from electronic medical records without direct patient involvement.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"353"}}