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dc.titleCardiovascular outcomes with sodium–glucose cotransporter-2 inhibitors vs other glucose-lowering drugs in 13 countries across three continents: analysis of CVD-REAL data
dc.contributor.authorKhunti, Kamlesh
dc.contributor.authorKosiborod, Mikhail
dc.contributor.authorKim, Dae Jung
dc.contributor.authorKohsaka, Shun
dc.contributor.authorLam, Carolyn S. P.
dc.contributor.authorGoh, Su-Yen
dc.contributor.authorChiang, Chern-En
dc.contributor.authorShaw, Jonathan E.
dc.contributor.authorCavender, Matthew A.
dc.contributor.authorTangri, Navdeep
dc.contributor.authorFranch-Nadal, Josep
dc.contributor.authorHoll, Reinhard W.
dc.contributor.authorJørgensen, Marit E.
dc.contributor.authorNorhammar, Anna
dc.contributor.authorEriksson, Johan G.
dc.contributor.authorZaccardi, Francesco
dc.contributor.authorKarasik, Avraham
dc.contributor.authorMagliano, Dianna J.
dc.contributor.authorThuresson, Marcus
dc.contributor.authorChen, Hungta
dc.contributor.authorWittbrodt, Eric
dc.contributor.authorBodegård, Johan
dc.contributor.authorSurmont, Filip
dc.contributor.authorFenici, Peter
dc.contributor.authorWilding, John P.
dc.contributor.authorBirkeland, Kåre
dc.contributor.authorCarstensen, Bendix
dc.contributor.authorJørgensen, Marit E.
dc.contributor.authorLam, Carolyn S. P.
dc.contributor.authorKendrick, Rachel
dc.contributor.authorBelli, Wesley
dc.contributor.authorWittbrodt, Eric
dc.contributor.authorFranch-Nadal, Josep
dc.contributor.authorNoguchi, Yusuke
dc.contributor.authorTangri, Navdeep
dc.contributor.authorKohsaka, Shun
dc.contributor.authorKim, Dae Jung
dc.contributor.authorShaw, Jonathan E.
dc.contributor.authorAndersson-Sundell, Karolina
dc.contributor.authorGoh, Su-Yen
dc.contributor.authorChiang, Chern-En
dc.contributor.authorEriksson, Johan G.
dc.contributor.authorZaccardi, Francesco
dc.contributor.authorChen, Hungta
dc.contributor.authorKadir, Hanis Abdul
dc.contributor.authorHa, Kyoung Hwa
dc.contributor.authorLee, Jinhee
dc.contributor.authorChodick, Gabriel
dc.contributor.authorCohen, Cheli Melzer
dc.contributor.authorWhitlock, Reid
dc.contributor.authorSoriano, Lucia Cea
dc.contributor.authorCantero, Oscar Fernándex
dc.contributor.authorMenzin, Jordan A.
dc.contributor.authorGuthrie, Matthew
dc.contributor.authorIlomaki, Jennie
dc.contributor.authorHoti, Fabian
dc.contributor.authorChristopher, Solomon
dc.contributor.authorVehkala, Minna
dc.identifier.citationKhunti, 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.
dc.description.abstractBackground: 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).
dc.publisherBioMed Central Ltd
dc.rightsAttribution 4.0 International
dc.sourceScopus OA2021
dc.subjectCardiovascular outcomes
dc.subjectHeart failure
dc.subjectSodium–glucose cotransporter-2 inhibitors
dc.subjectType 2 diabetes
dc.contributor.departmentDEAN'S OFFICE (DUKE-NUS MEDICAL SCHOOL)
dc.contributor.departmentOBSTETRICS & GYNAECOLOGY
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.sourcetitleCardiovascular Diabetology
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