eprintid: 10076979
rev_number: 40
eprint_status: archive
userid: 608
dir: disk0/10/07/69/79
datestamp: 2019-06-28 16:38:45
lastmod: 2021-09-19 22:53:26
status_changed: 2019-11-06 16:35:41
type: article
metadata_visibility: show
creators_name: Mahaffey, KW
creators_name: Jardine, M
creators_name: Bompoint, S
creators_name: Cannon, C
creators_name: Bruce, N
creators_name: Herspink, LHJ
creators_name: Charytan, D
creators_name: Edwards, R
creators_name: Bull, S
creators_name: Capuano, G
creators_name: De Zeeuw, D
creators_name: Levin, A
creators_name: Pollock, C
creators_name: Wheeler, DC
creators_name: Yavin, Y
creators_name: Zinman, B
creators_name: Rosenthal, N
creators_name: Brenner, BM
creators_name: Perkovic, V
title: Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups: Results From the Randomized CREDENCE Trial
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D17
divisions: G93
keywords: canagliflozin, primary prevention, secondary prevention, cardiovascular outcomes, clinical trial, diabetes mellitus, chronic kidney disease
note: © 2019 The Authors. Circulation is
published on behalf of the American
Heart Association, Inc., by Wolters
Kluwer Health, Inc. This is an open
access article under the terms of
the Creative Commons Attribution
Non-Commercial-NoDerivs License,
which permits use, distribution, and
reproduction in any medium, provided
that the original work is properly cited,
the use is noncommercial, and no
modifications or adaptations are made
abstract: Background
Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without prior cardiovascular disease (primary prevention).
Methods
In CREDENCE, 4401 participants with type 2 diabetes and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. 
Results
Primary prevention participants (N=2181; 49.6%) were younger (61 vs 65 years), more often female (37% vs 31%), and had shorter diabetes duration (15 vs 16 years) compared to secondary prevention participants (N=2220; 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80; 95% confidence interval [CI] 0.67–0.95; P=0.01), with consistent reductions in both the primary (HR, 0.68; 95% CI, 0.49–0.94) and secondary (HR, 0.85; 95% CI, 0.69–1.06) prevention groups (P-interaction 0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78; 95% CI, 0.61–1.00), nonfatal myocardial infarction (HR, 0.81; 95% CI, 0.59–1.10), and nonfatal stroke (HR, 0.80; 95% CI, 0.56–1.15). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P-interaction >0.5 for each outcome).
Conclusions
Canagliflozin significantly reduced major cardiovascular events, as well as kidney failure, in patients with type 2 diabetes and chronic kidney disease, including in participants who did not have prior cardiovascular disease.
date: 2019-08-27
date_type: published
publisher: American Heart Association
official_url: https://doi.org/10.1161/CIRCULATIONAHA.119.042007
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1667813
doi: 10.1161/CIRCULATIONAHA.119.042007
lyricists_name: Wheeler, David
lyricists_id: DWHEE12
actors_name: Austen, Jennifer
actors_id: JAUST66
actors_role: owner
full_text_status: public
publication: Circulation
volume: 140
number: 9
pagerange: 739-750
issn: 0009-7322
citation:        Mahaffey, KW;    Jardine, M;    Bompoint, S;    Cannon, C;    Bruce, N;    Herspink, LHJ;    Charytan, D;                                                 ... Perkovic, V; + view all <#>        Mahaffey, KW;  Jardine, M;  Bompoint, S;  Cannon, C;  Bruce, N;  Herspink, LHJ;  Charytan, D;  Edwards, R;  Bull, S;  Capuano, G;  De Zeeuw, D;  Levin, A;  Pollock, C;  Wheeler, DC;  Yavin, Y;  Zinman, B;  Rosenthal, N;  Brenner, BM;  Perkovic, V;   - view fewer <#>    (2019)    Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups: Results From the Randomized CREDENCE Trial.                   Circulation , 140  (9)   pp. 739-750.    10.1161/CIRCULATIONAHA.119.042007 <https://doi.org/10.1161/CIRCULATIONAHA.119.042007>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10076979/1/Wheeler_CIRCULATIONAHA.119.042007.pdf