| アブストラクト | AIMS: To examine heart failure (HF) and chronic kidney disease (CKD) risks reduction associated with sodium-glucose cotransporter-2 inhibitors (SGLT-2i) compared to other glucose-lowering drugs (oGLD) in the early stage of type 2 diabetes patients without established cardiovascular or renal diseases (CVRD-free T2D). MATERIALS AND METHODS: We performed an observational cohort study using a Japanese hospital claims registry, Medical Data Vision. CVRD-free T2D patients were identified between 1 April 2014 and 30 September 2018. SGLT-2i and oGLD new users (and dipeptidyl peptidase 4 inhibitors [DPP-4i] separately) were subjected to 1:1 propensity-score matching analysis. Hazard ratios (HRs) of cardiorenal disease (HF and/or CKD), HF, CKD, stroke, myocardial infarction (MI), and all-cause mortality, were estimated using unadjusted Cox regression. RESULTS: A total of 108 362 CVRD-free patients including 54 181 SGLT-2i and 54 181 oGLD users were matched. Baseline characteristics were well balanced (mean age 59.1 years, 63% male, and follow-up 1.50 years [162 970 patient-years]). Compared to oGLD group, SGLT-2i group had lower risk of cardiorenal disease, HF, CKD, stroke, and all-cause mortality with HRs (95% confidence intervals) 0.55 (0.49-0.61), 0.73 (0.61-0.87), 0.45 (0.39-0.52), 0.69 (0.59-0.81), and 0.52 (0.46-0.58), respectively, while no difference in MI. These were consistent in 1:1 propensity-score matching analysis between SGLT-2i and DPP-4i users (n = 17 232 in each group). CONCLUSIONS: In Japanese CVRD-free T2D patients, SGLT-2i initiation was associated with lower risk of cardiorenal diseases, stroke, and all-cause mortality compared to oGLD, suggesting preventive effect of SGLT-2i treatment in the early stage of T2D patients without CVRD manifestation. |
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| ジャーナル名 | Diabetes, obesity & metabolism |
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| 投稿日 | 2021/4/10 |
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| 投稿者 | Komuro, Issei; Kadowaki, Takashi; Bodegard, Johan; Thuresson, Marcus; Okami, Suguru; Yajima, Toshitaka |
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| 組織名 | Department of Cardiovascular Medicine, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Toranomon Hospital, Tokyo, Japan.;AstraZeneca Oslo, Oslo, Norway.;Statisticon AB, Uppsala, Sweden.;Cardiovascular, Renal, and Metabolism, Medical Affairs, AstraZeneca K.K., Osaka,;Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33835641/ |
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