S331 Beyond Glycemic Control: Cardiovascular Outcomes of GLP-1/GIP Agonists in T2DM-IBD Patients

Introduction: Patients with coexisting type 2 diabetes mellitus (T2DM) and inflammatory bowel disease (IBD) face an increased risk of cardiovascular complications due to shared pathways of chronic inflammation, metabolic dysregulation, and immune-mediated vascular injury. Glucagon-like peptide-1 (GLP-1) and dual GLP-1/gastric inhibitory peptide (GIP) receptor agonists, such as semaglutide and tirzepatide, have demonstrated cardiometabolic benefits in diabetic populations. However, their impact on specific cardiac complications in patients with both T2DM and IBD remains understudied. Methods: We conducted a retrospective cohort study using the TriNetX global federated health research network, focusing on adults (≥18 years) with concurrent diagnoses of T2DM and IBD, including Crohn’s disease and ulcerative colitis. After matching, both cohorts consisted of 12,331 patients. Cohort 1 (n = 12,331): Patients with T2DM and IBD who were treated with semaglutide or tirzepatide. Cohort 2 (n = 12,331): Patients with T2DM and IBD who did not receive these agents. Propensity score matching was performed 1:1 on 51 covariates, including demographics, comorbidities (e.g., chronic kidney disease, chronic obstructive pulmonary disease, liver disease), relevant procedures, and concomitant medications. Results: GLP-1/GIP receptor agonist therapy was associated with significantly reduced risks for all analyzed cardiac outcomes in patients with type 2 diabetes mellitus and inflammatory bowel disease. The following relative risks (RR) and P-values were observed in the matched cohorts: myocardial infarction: RR 0.50, P < 0.001; heart failure: RR 0.58, P < 0.001; atrial fibrillation: RR 0.60, P < 0.001; ventricular fibrillation: RR 0.45, P < 0.001; pericarditis: RR 0.36, P < 0.001; AV Block (first degree): RR 0.67, P < 0.001; AV Block (second degree): RR 0.51, P < 0.001; complete AV Block: RR 0.49, P < 0.001; sudden cardiac death (proxy for cardiomyopathy): RR 0.52, P < 0.001. Conclusion: GLP-1 and dual GLP-1/GIP receptor agonists are associated with substantial reductions in cardiovascular risk among patients with T2DM and IBD. These findings underscore the potential benefit of these agents in cardiometabolic and inflammatory comorbidity management, supporting their broader use in high-risk populations.