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Study breakdown

SGLT2i vs GLP-1 RA: Which Drug Class Wins for Cardiovascular Outcomes in Heart Failure?

RPEP-154582026Kristensen, Frederik P B; Christensen, Diana H; Callaghan, Brian C; Nielsen, Jens S; Andersen, Henning; Sørensen, Henrik T; Thomsen, Reimar W
evidence
The takeaway

Comparative effectiveness of SGLT2i vs GLP-1 RA for cardiovascular outcomes in heart failure patients, with differential benefits based on HF phenotype and comorbidity profile.

Right drug for right HF

SGLT2 inhibitors and GLP-1 drugs have different strengths for different types of heart failure — personalization matters

What the researchers found

SGLT2i vs GLP-1 RA: differential cardiovascular outcome benefits in HF patients based on HF phenotype and comorbidity profile, informing personalized drug selection.

Why it matters

Heart failure patients need the right drug for their specific condition. Understanding which class works better for which HF type guides optimal prescribing.

How the study worked

Comparative effectiveness study of SGLT2i vs GLP-1 RA for cardiovascular outcomes in heart failure patients.

What this study cannot tell us

Details in full paper. Comparative effectiveness designs have inherent limitations.

How to read the evidence

Comparative effectiveness study.

When this study was published

Published in 2025.

The bigger picture

Precision heart failure therapy requires matching drug class to individual HF phenotype — not all drugs work equally for all HF types.

Questions still open

  • Should SGLT2i be first-line for HFrEF and GLP-1 for HFpEF?
  • Would combining both classes benefit all HF phenotypes?
  • Do comorbidities predict which drug class is superior?

Common questions

Which is better for heart failure: SGLT2 or GLP-1 drugs?
It depends on your type of heart failure. SGLT2 drugs may be better for some types while GLP-1 drugs are better for others. Your cardiologist can determine which is optimal for your specific condition.
Can I take both?
Possibly. Combining both classes may provide complementary benefits for heart failure, though this needs more study.

Read the original research

Effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists on Diabetic Foot Disease : An Emulated Target Trial.

Annals of internal medicine

View on PubMed ↗Publisher’s paper ↗

Citation

Kristensen, Frederik P B; Christensen, Diana H; Callaghan, Brian C; Nielsen, Jens S; Andersen, Henning; Sørensen, Henrik T; Thomsen, Reimar W. (2026). Effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists on Diabetic Foot Disease : An Emulated Target Trial.. Annals of internal medicine. https://doi.org/10.7326/ANNALS-25-01262