Cardiovascular 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.author | Khunti, Kamlesh | |
dc.contributor.author | Kosiborod, Mikhail | |
dc.contributor.author | Kim, Dae J. | |
dc.contributor.author | Kohsaka, Shun | |
dc.contributor.author | Lam, Carolyn S. P. | |
dc.contributor.author | Goh, Su-Yen | |
dc.contributor.author | Chiang, Chern-En | |
dc.contributor.author | Shaw, Jonathan E. | |
dc.contributor.author | Cavender, Matthew A. | |
dc.contributor.author | Tangri, Navdeep | |
dc.contributor.author | Franch-Nadal, Josep | |
dc.contributor.author | Holl, Reinhard W. | |
dc.contributor.author | Jørgensen, Marit E. | |
dc.contributor.author | Norhammar, Anna | |
dc.contributor.author | Eriksson, Johan G. | |
dc.contributor.author | Zaccardi, Francesco | |
dc.contributor.author | Karasik, Avraham | |
dc.contributor.author | Magliano, Dianna J. | |
dc.contributor.author | Thuresson, Marcus | |
dc.contributor.author | Chen, Hungta | |
dc.contributor.author | Wittbrodt, Eric | |
dc.contributor.author | Bodegård, Johan | |
dc.contributor.author | Surmont, Filip | |
dc.contributor.author | Fenici, Peter | |
dc.date.accessioned | 2021-08-01T03:17:38Z | |
dc.date.issued | 2021-07-31 | |
dc.identifier.citation | Cardiovascular Diabetology. 2021 Jul 31;20(1):159 | |
dc.identifier.uri | https://doi.org/10.1186/s12933-021-01345-z | |
dc.identifier.uri | http://hdl.handle.net/1993/35768 | |
dc.description.abstract | Abstract Background 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 | |
dc.rights | open access | en_US |
dc.title | Cardiovascular outcomes with sodium–glucose cotransporter-2 inhibitors vs other glucose-lowering drugs in 13 countries across three continents: analysis of CVD-REAL data | |
dc.type | Journal Article | |
dc.language.rfc3066 | en | |
dc.rights.holder | The Author(s) | |
dc.date.updated | 2021-08-01T03:17:38Z | |
local.author.affiliation | Rady Faculty of Health Sciences | en_US |
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