Cardiovascular and renal outcomes with varying degrees of kidney disease in high-risk people with type 2 diabetes: An epidemiological analysis of data from the AMPLITUDE-O trial.

Autor: Gerstein HC; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.; Department of Medicine, Master University, Hamilton, Ontario, Canada., Mian R; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada., Ramasundarahettige C; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada., Branch KRH; Division of Cardiology, University of Washington, Seattle, Washington, USA., Del Prato S; Interdisciplinary Research Center 'Health Science' of the Sant'Anna School of Advanced Studies, Pisa, Italy., Lam CSP; National Heart Centre Singapore and Duke-National University of Singapore, Singapore, Singapore., Lopes RD; Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA., Pratley R; AdventHealth Translational Research Institute, Orlando, Florida, USA., Rosenstock J; Velocity Clinical Research at Medical City, Dallas, Texas, USA., Sattar N; School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
Jazyk: angličtina
Zdroj: Diabetes, obesity & metabolism [Diabetes Obes Metab] 2024 Apr; Vol. 26 (4), pp. 1216-1223. Date of Electronic Publication: 2023 Dec 20.
DOI: 10.1111/dom.15417
Abstrakt: Aims: To estimate the incidence of a major adverse cardiovascular event (MACE) and a composite kidney outcome across estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) levels, and to determine whether efpeglenatide's effect varies with these indices.
Materials and Methods: AMPLITUDE-O trial data were used to estimate the relationship of eGFR, UACR, and Kidney Disease Improving Global Outcomes (KDIGO) category to the hazard of MACE and the kidney composite. Interactions on these outcomes between eGFR and the UACR, and between each of these variables and efpeglenatide were also assessed.
Results: Baseline eGFR and UACR were available for 3983 participants (mean age 64.5 years). During a median follow-up of 1.8 years, the hazards of MACE and the kidney composite for the lowest versus highest eGFR third were 1.6 (95% confidence interval [CI] 1.2, 2.2) and 2.3 (95% CI 1.9, 2.8), respectively. The hazards for the highest versus the lowest UACR third were 2.3 (95% CI 1.8, 3.1) and 18.0 (95% CI 12.7, 25.5), respectively, and for the high- versus low-risk KDIGO categories the hazards were 2.4 (95% CI 1.8, 3.1) and 16.0 (95% CI 11.6, 22.0), respectively. eGFR and UACR were independent determinants of both outcomes, but negatively interacted with each other for the kidney outcome. Efpeglenatide's effect on both outcomes did not vary with any kidney disease measure (all interaction p values ≥0.26).
Conclusions: In high-risk people with diabetes, eGFR, UACR, and KDIGO category have different relationships to incident cardiovascular and kidney outcomes. The beneficial effect of efpeglenatide on these outcomes is independent of kidney-related risk category.
(© 2023 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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