| アブストラクト | AIMS: Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) are antidiabetic agents that can have direct cardiac effects by impacting on cardiac ion transport mechanisms that control cardiac electrophysiology. We studied the association between SGLT-2i use and all-cause mortality and the risk of sudden cardiac arrest (SCA) in patients with type 2 diabetes. METHODS: Using data from the UK Clinical Practice Research Datalink, a cohort study among patients initiating a new antidiabetic drug class on or after January 2013 through September 2020 was conducted. A Cox regression with time-dependent covariates was performed to estimate the hazard ratios (HRs) of SCA and all-cause mortality comparing SGLT-2is with other second- to third-line antidiabetic drugs. Stratified analyses were performed according to sex, diabetes duration (<5 or >/=5 years), and the presence of cardiovascular disease. RESULTS: A total of 152 591 patients were included. Use of SGLT-2i was associated with a reduced HR of SCA when compared with other second- to third-line antidiabetic drugs after adjustment for common SCA risk factors, although this association marginally failed to reach statistical significance [HR: 0.62, 95% confidence interval (95% CI): 0.38-1.01]. The HR of all-cause mortality associated with SGLT-2i use when compared with other second- to third-line antidiabetics was 0.43 (95% CI: 0.39-0.48) and did not vary by sex, diabetes duration, or the presence of cardiovascular disease. SGLT-2i use remained associated with lower all-cause mortality in patients without concomitant insulin use (HR: 0.56, 95% CI: 0.50-0.63). CONCLUSION: SGLT-2i use was associated with reduced all-cause mortality in patients with type 2 diabetes. The association between use of SGLT-2i and reduced risk of SCA was not statistically significant. |
|---|
| 組織名 | Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for;Pharmaceutical Sciences, Utrecht University, 3584 CS Utrecht, The Netherlands.;Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte,;2900 Copenhagen, Denmark.;Department of Experimental and Clinical Cardiology, Amsterdam UMC, Academic;Medical Center, University of Amsterdam, Heart Centre, Amsterdam Cardiovascular;Sciences, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.;Department of Anaesthesiology, Laboratory of Experimental Intensive Care and;Anaesthesiology (L.E.I.C.A.), Amsterdam UMC, Location Academic Medical Centre;(AMC), University of Amsterdam, Cardiovascular Sciences, 1105 AZ Amsterdam, The;Netherlands.;General Practice, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan;1117, 1081 HV Amsterdam, The Netherlands.;Health Behaviors & Chronic Diseases, Amsterdam Public Health Research Institute,;1105 BP Amsterdam, The Netherlands. |
|---|
