Idris, I;
Zhang, R;
Mamza, JB;
Ford, M;
Morris, T;
Banerjee, A;
Khunti, K;
(2021)
Lower Risk of Hospitalisation for Heart Failure, Kidney Disease and Death with Sodium Glucose Co-Transporter-2 Compared to Dipeptidyl Peptidase-4 Inhibitors in Type 2 Diabetes Regardless of Prior Cardiovascular or Kidney Disease: A Retrospective Cohort Study in UK Primary Care.
Diabetes, Obesity and Metabolism
, 23
(10)
pp. 2207-2214.
10.1111/dom.14437.
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Abstract
Aim 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). Methods 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. Results 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). Conclusion 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.
Type: | Article |
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Title: | Lower Risk of Hospitalisation for Heart Failure, Kidney Disease and Death with Sodium Glucose Co-Transporter-2 Compared to Dipeptidyl Peptidase-4 Inhibitors in Type 2 Diabetes Regardless of Prior Cardiovascular or Kidney Disease: A Retrospective Cohort Study in UK Primary Care |
Location: | England |
Open access status: | An open access version is available from UCL Discovery |
DOI: | 10.1111/dom.14437 |
Publisher version: | https://doi.org/10.1111/dom.14437 |
Language: | English |
Additional information: | This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/ |
Keywords: | Cardiovascular disease, clinical trial, dapagliflozin, diabetes complications, dipeptidyl peptidase-4 inhibitor, heart failure |
UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics |
URI: | https://discovery.ucl.ac.uk/id/eprint/10130075 |
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