Cardiovascular Benefit of Empagliflozin Across the Spectrum of Cardiovascular Risk Factor Control in the EMPA-REG OUTCOME Trial
Autor: | Bernard Zinman, Michaela Mattheus, Silvio E. Inzucchi, Jyothis T. George, Kamlesh Khunti, Anne Pernille Ofstad, David Fitchett, Christoph Wanner |
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Rok vydání: | 2020 |
Předmět: |
Blood Glucose
Male Endocrinology Diabetes and Metabolism cardioprotective Clinical Biochemistry Type 2 diabetes Cardiovascular System Biochemistry chemistry.chemical_compound Endocrinology Glucosides Risk Factors cardiovascular disease Medicine education.field_of_study Hazard ratio Middle Aged Hospitalization Treatment Outcome Cardiovascular Diseases Female type 2 diabetes AcademicSubjects/MED00250 medicine.medical_specialty Cardiotonic Agents Population Context (language use) Risk Assessment Internal medicine Post-hoc analysis Empagliflozin Humans Benzhydryl Compounds Risk factor education Clinical Research Articles Aged Retrospective Studies Glycated Hemoglobin Heart Failure business.industry Biochemistry (medical) medicine.disease Diabetes Mellitus Type 2 chemistry Heart Disease Risk Factors Glycated hemoglobin business Follow-Up Studies |
Zdroj: | The Journal of Clinical Endocrinology and Metabolism |
ISSN: | 1945-7197 0021-972X |
Popis: | Context Control of multiple cardiovascular (CV) risk factors reduces CV events in individuals with type 2 diabetes. Objective To investigate this association in a contemporary clinical trial population, including how CV risk factor control affects the CV benefits of empagliflozin, a sodium-glucose cotransporter-2 inhibitor. Design Post hoc analysis. Setting Randomized CV outcome trial (EMPA-REG OUTCOME). Participants Type 2 diabetes patients with established CV disease. Intervention Empagliflozin or placebo. Main Outcome Measures Risk of CV outcomes—including the treatment effect of empagliflozin—by achieving 7 goals for CV risk factor control at baseline: (1) glycated hemoglobin Results In the placebo group, the hazard ratio (HR) for CV death was 4.00 (95% CI, 2.26–7.11) and 2.48 (95% CI, 1.52–4.06) for patients achieving only 0–3 or 4–5 risk factor goals at baseline, respectively, compared with those achieving 6–7 goals. Participants achieving 0–3 or 4–5 goals also had increased risk for the composite outcome of hospitalization for heart failure or CV death (excluding fatal stroke) (HR 2.89 [1.82–4.57] and 1.90 [1.31–2.78], respectively) and 3-point major adverse CV events (HR 2.21 [1.53–3.19] and 1.42 [1.06–1.89]). Empagliflozin significantly reduced these outcomes across all risk factor control categories (P > 0.05 for treatment-by-subgroup interactions). Conclusions Cardiovascular risk in EMPA-REG OUTCOME was inversely associated with baseline CV risk factor control. Empagliflozin’s cardioprotective effect was consistent regardless of multiple baseline risk factor control. |
Databáze: | OpenAIRE |
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