Cardiovascular outcomes with sodium-glucose cotransporter-2 inhibitors vs other glucose-lowering drugs in 13 countries across three continents : analysis of CVD-REAL data

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CVD-REAL Investigators Study Grp , Khunti , K , Kosiborod , M , Kim , D J , Eriksson , J G & Fenici , P 2021 , ' Cardiovascular outcomes with sodium-glucose cotransporter-2 inhibitors vs other glucose-lowering drugs in 13 countries across three continents : analysis of CVD-REAL data ' , Cardiovascular Diabetology , vol. 20 , no. 1 , 159 . https://doi.org/10.1186/s12933-021-01345-z

Titel: Cardiovascular outcomes with sodium-glucose cotransporter-2 inhibitors vs other glucose-lowering drugs in 13 countries across three continents : analysis of CVD-REAL data
Författare: CVD-REAL Investigators Study Grp; Khunti, Kamlesh; Kosiborod, Mikhail; Kim, Dae Jung; Eriksson, Johan G.; Fenici, Peter
Upphovmannens organisation: Clinicum
Research Programs Unit
Johan Eriksson / Principal Investigator
Department of General Practice and Primary Health Care
Datum: 2021-07-31
Språk: eng
Sidantal: 15
Tillhör serie: Cardiovascular Diabetology
ISSN: 1475-2840
DOI: https://doi.org/10.1186/s12933-021-01345-z
Permanenta länken (URI): http://hdl.handle.net/10138/334647
Abstrakt: Background Randomized, controlled cardiovascular outcome trials may not be fully representative of the management of patients with type 2 diabetes across different geographic regions. We conducted analyses of data from the multinational CVD-REAL consortium to determine the association between initiation of sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and cardiovascular outcomes, including subgroup analyses based on patient characteristics. Methods De-identified health records from 13 countries across three continents were used to identify patients newly-initiated on SGLT-2i or other glucose-lowering drugs (oGLDs). Propensity scores for SGLT-2i initiation were developed in each country, with 1:1 matching for oGLD initiation. In the matched groups hazard ratios (HRs) for hospitalization for heart failure (HHF), all-cause death (ACD), the composite of HHF or ACD, myocardial infarction (MI) and stroke were estimated by country, and pooled using a weighted meta-analysis. Multiple subgroup analyses were conducted across patient demographic and clinical characteristics to examine any heterogeneity in treatment effects. Results Following matching, 440,599 new users of SGLT-2i and oGLDs were included in each group. Mean follow-up time was 396 days for SGLT-2i initiation and 406 days for oGLDs initiation. SGLT-2i initiation was associated with a lower risk of HHF (HR: 0.66, 95%CI 0.58-0.75; p < 0.001), ACD (HR: 0.52, 95%CI 0.45-0.60; p < 0.001), the composite of HHF or ACD (HR: 0.60, 95%CI 0.53-0.68; p < 0.001), MI (HR: 0.85, 95%CI 0.78-0.92; p < 0.001), and stroke (HR: 0.78, 95%CI 0.72-0.85; p < 0.001); regardless of patient characteristics, including established cardiovascular disease, or geographic region. Conclusions This CVD-REAL study extends the findings from the SGLT-2i clinical trials to the broader setting of an ethnically and geographically diverse population, and across multiple subgroups. Trial registration NCT02993614
Subject: Sodium-glucose cotransporter-2 inhibitors
Cardiovascular outcomes
Heart failure
Type 2 diabetes
RISK
INITIATION
THERAPIES
MORTALITY
TRIALS
DEATH
ASIA
3121 General medicine, internal medicine and other clinical medicine
Referentgranskad: Ja
Licens: cc_by
Användningsbegränsning: openAccess
Parallelpublicerad version: publishedVersion


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