Cardiovascular and mortality benefits of sodium-glucose co-transporter-2 inhibitors in patients with type 2 diabetes mellitus: CVD-Real Catalonia
Por:
Real, J, Vlacho, B, Ortega, E, Valles, JA, Mata-Cases, M, Castelblanco, E, Wittbrodt, ET, Fenici, P, Kosiborod, M, Mauricio, D, Franch-Nadal, J
Publicada:
9 jul 2021
Resumen:
Background Evidence from prospective cardiovascular (CV) outcome trials in type 2 diabetes (T2DM) patients supports the use of sodium-glucose co-transporter-2 inhibitors (SGLT2i) to reduce the risk of CV events. In this study, we compared the risk of several CV outcomes between new users of SGLT2i and other glucose-lowering drugs (oGLDs) in Catalonia, Spain. Methods CVD-REAL Catalonia was a retrospective cohort study using real-world data routinely collected between 2013 and 2016. The cohorts of new users of SGLT2i and oGLDs were matched by propensity score on a 1:1 ratio. We compared the incidence rates and hazard ratio (HR) for all-cause death, hospitalization for heart failure, chronic kidney disease, and modified major adverse CV event (MACE; all-cause mortality, myocardial infarction, or stroke). Results After propensity score matching, 12,917 new users were included in each group. About 27% of users had a previous history of CV disease. In the SGLT2i group, the exposure time was 60% for dapagliflozin, 26% for empagliflozin and 14% for canagliflozin. The use of SGLT2i was associated with a lower risk of heart failure (HR: 0.59; 95% confidence interval [CI] 0.47-0.74; p < 0.001), all-cause death (HR = 0.41; 95% CI 0.31-0.54; p < 0.001), all-cause death or heart failure (HR = 0.55; 95% CI 0.47-0.63; p < 0.001), modified MACE (HR = 0.62; 95% CI 0.52-0.74; p < 0.001), and chronic kidney disease (HR = 0.66; 95% CI 0.54-0.80; p < 0.001). Conclusions In this large, retrospective observational study of patients with T2DM from a Catalonia, initiation of SGLT-2i was associated with lower risk of mortality, as well as heart failure and CKD.
Filiaciones:
Real, J:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid, Spain
Vlacho, B:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona, Spain
Ortega, E:
Hosp Clin Barcelona, Inst Invest Biomed August Pi i Suner, Dept Endocrinol & Nutr, Barcelona, Spain
Inst Salud Carlos III ISCIII, CIBER Physiopathol Obes & Nutr CIBEROBN, Madrid, Spain
Valles, JA:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona, Spain
Inst Catala Salut, Gerencia Atencio Primaria, Drug Area, Barcelona, Spain
Mata-Cases, M:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid, Spain
Inst Catala Salut, Gerencia Ambit Atencio Primaria Barcelona Ciutat, Primary Hlth Care Ctr La Mina, St Adria De Besos, Spain
Castelblanco, E:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid, Spain
Wittbrodt, ET:
AstraZeneca, Gaithersburg, MD USA
Fenici, P:
AstraZeneca, BioPharmaceut Global Med, Cardiovasc Renal Metab, Cambridge, England
Kosiborod, M:
St Lukes Mid Amer Heart Inst, Kansas City, MO USA
Univ Missouri, Kansas City, MO 64110 USA
Mauricio, D:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid, Spain
Autonomous Univ Barcelona, Hosp Univ Santa Creu & St Pau, Dept Endocrinol & Nutr, St Quinti 89, Barcelona 08041, Spain
Cent Univ Catalonia, Univ Vic, Dept Med, Barcelona, Spain
Franch-Nadal, J:
Fundacio Inst Univ Recerca Atencio Primaria Salut, Unitat Suport Recerca Barcelona, DAP Cat Grp, Barcelona, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Madrid, Spain
Inst Catala Salut, Gerencia Atencio Primaria, Primary Hlth Care Ctr Raval Sud, Av Drassanes 17-21, Barcelona 08001, Spain
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