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Cardiovascular outcomes associated with prescription of SGLT-2 inhibitors vs DPP-4 inhibitors in patients with diabetes mellitus and chronic kidney disease

Diabetes, Obesity and Metabolism Feb 08, 2022

In this study, incident prescription of sodium glucose cotransporter-2 (SGLT-2) inhibitors was shown to be linked with lower risks of heart failure (HF) hospitalization but not with non-fatal myocardial infarction (MI) or stroke despite indicating advantage, compared with prescription of dipeptidyl peptidase-4 (DPP-4) inhibitors across different stages of chronic kidney disease (CKD).

  • Using data from Optum Clinformatics DataMart, new users of SGLT-2 inhibitors and DPP-4 inhibitors with type 2 diabetes mellitus (T2DM) and CKD were included in this population-based cohort study: T2DM/no CKD, T2DM/CKD 1-2, and T2DM/ CKD 3a were the three cohorts analyzed.

  • Lower risks of HF hospitalization in the T2DM/no CKD (hazard ratio:HR, 0.76) and T2DM/CKD 1-2 (HR, 0.63) cohorts were observed among new users of SGLT-2 inhibitors vs of DPP-4 inhibitors, however there was no significant association in the T2DM/CKD 3a cohort.

  • Relative to DPP-4 inhibitors, SGLT-2 inhibitors were found to be linked with lower risks of non-fatal MI or stroke of 23% (HR, 0.77) in the T2DM/no CKD cohort, but no significant links were found in the T2DM/CKD 1-2 and T2DM/CKD 3a cohorts.

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