Cavender, Matthew A, Norhammar, Anna, Birkeland, Kare I, Jorgensen, Marit Eika, Wilding, John P 
ORCID: 0000-0003-2839-8404, Khunti, Kamlesh, Fu, Alex Z, Bodegard, Johan, Blak, Betina T, Wittbrodt, Eric et al (show 4 more authors)
(2018)
SGLT-2 Inhibitors and Cardiovascular Risk An Analysis of CVD-REAL.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 71 (22).
pp. 2497-2506.
Abstract
<h4>Background</h4>Prior studies found patients treated with sodium-glucose co-transporter-2 inhibitors (SGLT-2i) had lower rates of death and heart failure (HF). Whether the benefits of SGLT-2i vary based upon the presence of cardiovascular disease (CVD) is unknown.<h4>Objectives</h4>This study sought to determine the association between initiation of SGLT-2i therapy and HF or death in patients with and without CVD.<h4>Methods</h4>The CVD-REAL (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors) study was a multinational, observational study in which adults with type 2 diabetes were identified. Patients prescribed an SGLT-2i or other glucose-lowering drugs (GLDs) were matched based on a propensity score for initiation of an SGLT-2i. Hazard ratios (HRs) for the risk of death, HF, and HF or death in patients with and without established CVD were estimated for each country and pooled.<h4>Results</h4>After propensity score matching, 153,078 patients were included in each group. At baseline, 13% had established CVD. Compared with therapy using other GLDs, initiation of an SGLT-2i was associated with lower risk of death in patients with and without CVD (HR: 0.56; 95% confidence interval [CI]: 0.44 to 0.70; and HR: 0.56; 95% CI: 0.50 to 0.63, respectively). There were also associations between SGLT-2i and lower risk of HF (HR: 0.72; 95% CI: 0.63 to 0.82; and HR: 0.61; 95% CI: 0.48 to 0.78, respectively) and the composite of HF or death (HR: 0.63; 95% CI: 0.57 to 0.70; and HR: 0.56; 95% CI: 0.50 to 0.62, respectively) observed in patients with and without established CVD.<h4>Conclusions</h4>In this large, multinational, observational study, initiation of SGLT-2i was associated with lower risk of death and HF regardless of pre-existing CVD. Ongoing clinical trials will provide further evidence regarding the benefit of SGLT-2i in patients without established CVD. (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors [CVD-REAL]; NCT02993614).
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | cardiovascular disease, CVD-REAL, heart failure, sodium-glucose co-transporter 2 inhibitors |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 20 Jul 2018 10:19 |
| Last Modified: | 24 Jan 2024 14:42 |
| DOI: | 10.1016/j.jacc.2018.01.085 |
| Open Access URL: | https://reader.elsevier.com/reader/sd/FB94BD6DBD23... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3023981 |
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