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Cardiovascular, Renal, and Metabolic Outcomes of Dapagliflozin Versus Placebo in a Primary Cardiovascular Prevention Cohort: Analyses From DECLARE-TIMI 58.
- Source :
-
Diabetes Care . May2021, Vol. 44 Issue 5, p1159-1167. 9p. - Publication Year :
- 2021
-
Abstract
- <bold>Objective: </bold>International guidelines propose prescribing sodium-glucose cotransporter 2 (SGLT2) inhibitors to patients with type 2 diabetes (T2D) as secondary prevention in patients with established atherosclerotic cardiovascular disease (ASCVD) or for primary prevention of cardiovascular events in high-risk patients with multiple risk factors (MRF) for ASCVD. The current analyses expand on the cardiovascular renal and metabolic effects of SGLT2 inhibitors in MRF patients.<bold>Research Design and Methods: </bold>In DECLARE-TIMI 58, 17,160 patients with T2D and MRF (59.4%) or established ASCVD (40.6%) were randomized to dapagliflozin versus placebo; patients were followed for a median of 4.2 years. The cardiovascular and renal outcomes in the MRF cohort were studied across clinically relevant subgroups for treatment effect and subgroup-based treatment interaction.<bold>Results: </bold>Among patients with MRF, the reduction with dapagliflozin in risk of cardiovascular death or hospitalization for heart failure (CVD/HHF) (hazard ratio [HR] 0.84, 95% CI 0.67-1.04) and the renal-specific outcome (HR 0.51, 95% CI 0.37-0.69) did not differ from that for patients with ASCVD (Pinteraction 0.99 and 0.72, respectively). The effect on CVD/HHF was entirely driven by a reduction in HHF (HR 0.64, 95% CI 0.46-0.88). The benefits of dapagliflozin on HHF and on the renal-specific outcome, among the subset with MRF, were directionally consistent across clinically relevant subgroups. At 48 months, HbA1c, weight, systolic blood pressure, and urinary albumin-to-creatinine ratio were lower with dapagliflozin versus placebo and estimated glomerular filtration rate was higher (P < 0.001).<bold>Conclusions: </bold>In patients with T2D and MRF, dapagliflozin reduced the risk of HHF and adverse renal outcomes regardless of baseline characteristics. These analyses support the benefit of dapagliflozin for important outcomes in a broad primary prevention population. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TYPE 2 diabetes
*DAPAGLIFLOZIN
*COHORT analysis
*SYSTOLIC blood pressure
*SECONDARY prevention
*HEART failure
*CARDIOVASCULAR disease prevention
*BENZENE
*RESEARCH
*RESEARCH methodology
*GLYCOSIDES
*MEDICAL cooperation
*EVALUATION research
*TREATMENT effectiveness
*PREVENTIVE health services
*COMPARATIVE studies
Subjects
Details
- Language :
- English
- ISSN :
- 01495992
- Volume :
- 44
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Diabetes Care
- Publication Type :
- Academic Journal
- Accession number :
- 150337154
- Full Text :
- https://doi.org/10.2337/dc20-2492