Cardiovascular and renal outcomes of GLP-1 receptor agonists vs. DPP-4 inhibitors and basal insulin in type 2 diabetes mellitus: A systematic review and meta-analysis.

Lastly, most real-world studies are limited by the lack of information regarding diabetes duration and variables such as HbA 1c levels, other co-existing metabolic conditions and anthropometric features at baseline and during follow-up, which may be significant predictors of cardiovascular risk. 9 , 37 , 43 For instance, CVOTs have suggested that HbA 1c reduction was a relevant mediator of the GLP-1 RA beneficial effect on MACE, and this association seemed to be driven by that between HbA 1c lowering and stroke. 44 , 45 Hence, the unavailability of data regarding baseline levels and changes in cardiovascular risk factors represents a limitation of most real-world studies investigating cardiovascular outcomes that might have hindered the interpretation of results.

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