1. Dulaglutide and cardiovascular and heart failure outcomes in patients with and without heart failure: a post‐hoc analysis from the REWIND randomized trial.
- Author
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Branch, Kelley R.H., Dagenais, Gilles R., Avezum, Alvaro, Basile, Jan, Conget, Ignacio, Cushman, William C., Jansky, Petr, Lakshmanan, Mark, Lanas, Fernando, Leiter, Lawrence A., Pais, Prem, Pogosova, Nana, Raubenheimer, Peter J., Ryden, Lars, Shaw, Jonathan E., Sheu, Wayne H.H., Temelkova‐Kurktschiev, Theodora, Bethel, M. Angelyn, Gerstein, Hertzel C., and Chinthanie, Ramasundarahettige
- Abstract
Aims: People with diabetes are at high risk for cardiovascular events including heart failure (HF). We examined the effect of the glucagon‐like peptide 1 agonist dulaglutide on incident HF events and other cardiovascular outcomes in those with or without prior HF in the randomized placebo‐controlled Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) trial. Methods and results: The REWIND major adverse cardiovascular event (MACE) outcome was the first occurrence of a composite endpoint of non‐fatal myocardial infarction, non‐fatal stroke, or death from cardiovascular causes (including unknown causes). In this post‐hoc analysis, a HF event was defined as an adjudication‐confirmed hospitalization or urgent evaluation for HF. Of the 9901 participants studied over a median follow‐up of 5.4 years, 213/4949 (4.3%) randomly assigned to dulaglutide and 226/4952 (4.6%) participants assigned to placebo experienced a HF event (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.77–1.12; p = 0.456). In the 853 (8.6%) participants with HF at baseline, there was no change in either MACE or HF events with dulaglutide as compared to participants without HF (p = 0.44 and 0.19 for interaction, respectively). Combined cardiovascular death and HF events were marginally reduced with dulaglutide compared to placebo (HR 0.88, 95% CI 0.78–1.00; p = 0.050) but unchanged in patients with and without HF at baseline (p = 0.31). Conclusions: Dulaglutide was not associated with a reduction in HF events in patients with type 2 diabetes regardless of baseline HF status over 5.4 years of follow‐up. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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