Comparative cardiovascular and renal effectiveness of empagliflozin and dapagliflozin: Scandinavian cohort study.

Autor:	Engström A; Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Stockholm 171 77, Sweden., Söderling J; Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Stockholm 171 77, Sweden., Hviid A; Department of Epidemiology Research, Statens Serum Institut, DK-2300 Copenhagens, Denmark.; Pharmacovigilance Research Center, Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, DK-1165 Copenhagen, Denmark., Eliasson B; Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg 405 30, Sweden., Gudbjörnsdottir S; Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg 405 30, Sweden.; The Swedish National Diabetes Register, Vastra Gotalandsregionen, Gothenburg 413 45, Sweden., Wintzell V; Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Stockholm 171 77, Sweden., Hveem K; HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim NO-7491, Norway.; HUNT Research Center, Faculty of Medicine, NTNU-Norwegian University of Science and Technology, Levanger 7600, Norway., Jonasson C; HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim NO-7491, Norway.; HUNT Research Center, Faculty of Medicine, NTNU-Norwegian University of Science and Technology, Levanger 7600, Norway., Melbye M; Department of Clinical Medicine, University of Copenhagen, DK-1165 Copenhagen, Denmark.; Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305-5176, USA.; HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU-Norwegian University of Science and Technology, Trondheim NO-7491, Norway.; Danish Cancer Institute, DK-2100 Copenhagen, Denmark., Pasternak B; Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Stockholm 171 77, Sweden.; Department of Epidemiology Research, Statens Serum Institut, DK-2300 Copenhagens, Denmark., Ueda P; Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Stockholm 171 77, Sweden.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular pharmacotherapy [Eur Heart J Cardiovasc Pharmacother] 2024 Aug 14; Vol. 10 (5), pp. 432-443.
DOI:	10.1093/ehjcvp/pvae045
Abstrakt:	Aims: To assess the comparative cardiovascular and renal effectiveness and safety of empagliflozin vs. dapagliflozin among patients with type 2 diabetes in routine clinical practice. Methods and Results: Cohort study using data from nationwide registers in Sweden, Denmark, and Norway, from June 2014 to June 2021 included 141 065 new users of empagliflozin and 58 306 new users of dapagliflozin. Coprimary outcomes were major cardiovascular events (myocardial infarction, stroke, and cardiovascular death), heart failure (hospitalization or death because of heart failure) and serious renal events (renal replacement therapy, hospitalization for renal events, and death from renal causes). Secondary outcomes were the individual components of the primary outcomes, any cause death, and diabetic ketoacidosis. Use of empagliflozin vs. dapagliflozin was associated with similar risk of major cardiovascular events [adjusted incidence rate: 15.9 vs. 15.8 events per 1000 person-years; HR 1.02, (95% confidence interval 0.97-1.08)], heart failure [6.5 vs. 6.3 events per 1000 person-years; HR 1.05 (0.97-1.14)] and serious renal events [3.7 vs. 4.1 events per 1000 person-years; HR 0.97 (0.87-1.07)]. In secondary outcome analyses, the HRs for use of empagliflozin vs. dapagliflozin were 1.00 (0.93-1.07) for myocardial infarction, 1.03 (0.95-1.12) for stroke, 1.01 (0.92-1.13) for cardiovascular death, 1.06 (1.00-1.11) for any cause death, 0.77 (0.60-0.99) for renal replacement therapy, 1.20 (0.75-1.93) for renal death, 1.01 (0.90-1.12) for hospitalization for renal events and 1.12 (0.94-1.33) for diabetic ketoacidosis. Conclusion: Use of empagliflozin and dapagliflozin was associated with similar risk of cardiovascular and renal outcomes, mortality, and diabetic ketoacidosis. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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