Lower risk of hospitalization for heart failure, kidney disease and death with sodium‐glucose co‐transporter‐2 inhibitors compared with dipeptidyl peptidase‐4 inhibitors in type 2 diabetes regardless of prior cardiovascular or kidney disease: A retrospective cohort study in UK primary care

Autor: Kamlesh Khunti, Tamsin Morris, Ruiqi Zhang, Iskandar Idris, Jil Billy Mamza, Amitava Banerjee, Mike Ford
Jazyk: angličtina
Rok vydání: 2021
Předmět:
medicine.medical_specialty
Endocrinology
Diabetes and Metabolism
Myocardial Infarction
Type 2 diabetes
Dipeptidyl peptidase-4 inhibitor
Lower risk
Endocrinology
cardiovascular disease
Internal medicine
Internal Medicine
medicine
Humans
Myocardial infarction
Renal Insufficiency
Chronic
Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
Stroke
Sodium-Glucose Transporter 2 Inhibitors
Retrospective Studies
Heart Failure
Dipeptidyl-Peptidase IV Inhibitors
Primary Health Care
Symporters
business.industry
Sodium
diabetes complications
Retrospective cohort study
clinical trial
Original Articles
dapagliflozin
medicine.disease
United Kingdom
Hospitalization
Glucose
Diabetes Mellitus
Type 2
Cardiovascular Diseases
Heart failure
Original Article
business
Kidney disease
medicine.drug
dipeptidyl peptidase‐4 inhibitor
Zdroj: Diabetes, Obesity & Metabolism
ISSN: 1463-1326
1462-8902
Popis: Aim: \ud To assess if sodium-glucose co-transporter-2 inhibitors (SGLT2is) reduce the risk of all-cause mortality, cardiovascular death and hospitalization for heart failure (HF) or chronic kidney disease (CKD) to a greater extent than dipeptidyl peptidase-4 inhibitors (DPP4is) in people with type 2 diabetes (T2D) with or without established cardiovascular and/or renal disease (CVRD).\ud \ud Methods: \ud This retrospective cohort study propensity-matched 24 438 patients receiving an SGLT2i 1:1 to a patient receiving a DDP4i, stratified based on the presence of CVRD. The primary outcomes were the time to each of the following: all-cause mortality, cardiovascular death or hospitalization for HF, myocardial infarction, stroke and CKD.\ud \ud Results: \ud Overall, SGLT2is were associated with reductions in all-cause mortality, cardiovascular mortality, hospitalization for HF and hospitalization for CKD compared with DPP4is. In patients with no CVRD history, SGLT2is were associated with reductions in all-cause mortality (HR 0.71, 95% CI 0.57-0.88; P = .002), hospitalization for HF (HR 0.76, 95% CI 0.59-0.98; P = .035) and hospitalization for CKD (HR 0.75, 95% CI 0.63-0.88; P < .001). In patients with established cardiovascular disease (CVD) or at high risk, SGLT2is were associated with reductions in all-cause mortality (HR 0.69, 95% CI 0.59-0.82; P < .001), cardiovascular mortality (HR 0.76, 95% CI 0.62-0.95; P = .014), hospitalization for HF (HR 0.73, 95% CI 0.63-0.85; P < .001), hospitalization for stroke (HR 0.75, 95% CI 0.59-0.94; P = .013) and hospitalization for CKD (HR 0.49, 95% CI 0.43-0.54; P < .001).\ud \ud Conclusion: \ud There was consistency across subgroups and sensitivity analyses. SGLT2is were associated with a reduced risk of all-cause mortality and hospitalization for HF and CKD compared with DPP4-is, highlighting the need to introduce SGLT2is early in the management of patients with T2D.
Databáze: OpenAIRE
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