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Title: | Cardiovascular outcomes with sodium–glucose cotransporter-2 inhibitors vs other glucose-lowering drugs in 13 countries across three continents: analysis of CVD-REAL data | Authors: | Khunti, Kamlesh Kosiborod, Mikhail Kim, Dae Jung Kohsaka, Shun Lam, Carolyn S. P. Goh, Su-Yen Chiang, Chern-En Shaw, Jonathan E. Cavender, Matthew A. Tangri, Navdeep Franch-Nadal, Josep Holl, Reinhard W. Jørgensen, Marit E. Norhammar, Anna Eriksson, Johan G. Zaccardi, Francesco Karasik, Avraham Magliano, Dianna J. Thuresson, Marcus Chen, Hungta Wittbrodt, Eric Bodegård, Johan Surmont, Filip Fenici, Peter Wilding, John P. Birkeland, Kåre Carstensen, Bendix Jørgensen, Marit E. Lam, Carolyn S. P. Kendrick, Rachel Belli, Wesley Wittbrodt, Eric Franch-Nadal, Josep Noguchi, Yusuke Tangri, Navdeep Kohsaka, Shun Kim, Dae Jung Shaw, Jonathan E. Andersson-Sundell, Karolina Goh, Su-Yen Chiang, Chern-En Eriksson, Johan G. Zaccardi, Francesco Chen, Hungta Kadir, Hanis Abdul Ha, Kyoung Hwa Lee, Jinhee Chodick, Gabriel Cohen, Cheli Melzer Whitlock, Reid Soriano, Lucia Cea Cantero, Oscar Fernándex Menzin, Jordan A. Guthrie, Matthew Ilomaki, Jennie Hoti, Fabian Christopher, Solomon Vehkala, Minna |
Keywords: | Cardiovascular outcomes Heart failure Sodium–glucose cotransporter-2 inhibitors Type 2 diabetes |
Issue Date: | 31-Jul-2021 | Publisher: | BioMed Central Ltd | Citation: | Khunti, Kamlesh, Kosiborod, Mikhail, Kim, Dae Jung, Kohsaka, Shun, Lam, Carolyn S. P., Goh, Su-Yen, Chiang, Chern-En, Shaw, Jonathan E., Cavender, Matthew A., Tangri, Navdeep, Franch-Nadal, Josep, Holl, Reinhard W., Jørgensen, Marit E., Norhammar, Anna, Eriksson, Johan G., Zaccardi, Francesco, Karasik, Avraham, Magliano, Dianna J., Thuresson, Marcus, Chen, Hungta, Wittbrodt, Eric, Bodegård, Johan, Surmont, Filip, Fenici, Peter, Wilding, John P., Birkeland, Kåre, Carstensen, Bendix, Jørgensen, Marit E., Lam, Carolyn S. P., Kendrick, Rachel, Belli, Wesley, Wittbrodt, Eric, Franch-Nadal, Josep, Noguchi, Yusuke, Tangri, Navdeep, Kohsaka, Shun, Kim, Dae Jung, Shaw, Jonathan E., Andersson-Sundell, Karolina, Goh, Su-Yen, Chiang, Chern-En, Eriksson, Johan G., Zaccardi, Francesco, Chen, Hungta, Kadir, Hanis Abdul, Ha, Kyoung Hwa, Lee, Jinhee, Chodick, Gabriel, Cohen, Cheli Melzer, Whitlock, Reid, Soriano, Lucia Cea, Cantero, Oscar Fernándex, Menzin, Jordan A., Guthrie, Matthew, Ilomaki, Jennie, Hoti, Fabian, Christopher, Solomon, Vehkala, Minna (2021-07-31). 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 20 (1) : 159. ScholarBank@NUS Repository. https://doi.org/10.1186/s12933-021-01345-z | Rights: | Attribution 4.0 International | Abstract: | 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 © 2021, The Author(s). | Source Title: | Cardiovascular Diabetology | URI: | https://scholarbank.nus.edu.sg/handle/10635/233558 | ISSN: | 1475-2840 | DOI: | 10.1186/s12933-021-01345-z | Rights: | Attribution 4.0 International |
Appears in Collections: | Elements Staff Publications |
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