# Retrospective real-world database study to examine the prevalence and incidence of cardiovascular diseases and medication prescription in Japanese patients with type 2 diabetes

## TL;DR

This study analyzed real-world data to assess cardiovascular disease prevalence and medication use in Japanese patients with type 2 diabetes from 2014 to 2021.

## Contribution

The study provides updated prevalence and incidence data for cardiovascular events and medication prescriptions in Japanese T2D patients using real-world databases.

## Key findings

- Prevalence of 3P-MACE and composite CVD remained stable from 2014 to 2021.
- Prescription rates of GLP-1RAs and SGLT-2is increased significantly over the study period.
- Patients with a history of CVD had higher incidence rates of cardiovascular events.

## Abstract

In Japan, real-world characterisation of cardiovascular disease (CVD) prevalence, incidence, and medication prescription in adults with type 2 diabetes (T2D) has been limited.

This real-world study (comprising a cross-sectional and a retrospective study) in adults aged ≥ 20 years with T2D used the Medical Data Vision database to evaluate the prevalence and incidence of three-point major adverse cardiovascular events (3P-MACE) and composite CVD and to describe medication prescription patterns.

The cross-sectional study included 292,383 patients in 2014 and 622,531 in 2021. Prevalence of 3P-MACE and composite CVD were 4.8% and 12.1%, respectively, in 2014; values in 2021 were 5.0% and 14.0%. In 2014, 2.1% of patients received glucagon-like peptide-1 receptor agonists (GLP-1RAs) and 0.8% received sodium-glucose cotransporter-2 inhibitors (SGLT-2is); 2021 values were 9.2% and 32.3%. The retrospective study included 314,206 patients; 19.7% had a CVD history. The overall incidence rate of 3P-MACE per 1000 person-years was 12.8 (95% confidence interval [CI] 12.6–13.0); 46.6 (45.3–48.0) in those with and 8.6 (8.4–8.8) in those without CVD history. The incidence rates (95% CI) of composite CVD were 47.9 (47.4–48.3); 179.5 (177.0–182.1) in those with and 31.5 (31.1–31.9) in those without CVD history.

In Japan, the prevalence of 3P-MACE and composite CVD were almost unchanged from 2014 to 2021, whereas GLP-1RA/SGLT-2i prescriptions increased. Incidence rates of 3P-MACE and composite CVD were higher in patients with a CVD history. These data provide insights into prescription patterns in T2D in Japan and could inform future treatment practices.

The online version contains supplementary material available at 10.1007/s13340-026-00877-7.