Cardiorenal outcomes and mortality after sodium‐glucose cotransporter‐2 inhibitor initiation in type 2 diabetes patients with percutaneous coronary intervention history
Authors' conclusion
The initiation of SGLT2 inhibitors in patients with type 2 diabetes and a history of PCI was significantly associated with a reduced risk of cardiorenal consequences and mortality, irrespective of time since the last PCI.
Study context
- Population
- Patients with T2D and a history of Percutaneous Coronary Intervention (PCI), National Health Insurance Service, South Korea, 2014–2019of 56,392 with PCI
- Exposure
- SGLT2i initiation vs DPP-4i initiation
- SGLT2 inhibitorsn = 4,610
- Outcome
- Composite of:
- Repeat revascularization
- MI
- Stroke
- HF
- All-cause death
- End-stage renal disease (ESRD)
- Follow-up
- 13 708.59 person-years of follow-up
Methodological detailsactive-comparator, new-user design, propensity-score matching 1:1
- Active-comparator, new-user design
- Propensity-score matching 1:1
Main finding
As reported in the abstract
Composite of:
- Repeat revascularization
- MI
- Stroke
- HF
- All-cause death
- ESRD
- SGLT2i initiation vs DPP-4i initiation associated with significantly lower risk of the composite outcome
- Propensity-score matched
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| HF (cohort with health examination data)SGLT2ivs DPP-4i | 0.574 (0.36–0.915) | |
| All-cause death (cohort with health examination data)SGLT2ivs DPP-4i | 0.731 (0.567–0.942) | |
| ESRD (cohort with health examination data)SGLT2ivs DPP-4i | 0.076 (0.018–0.319) | |
| 0.050.21520Hazard ratio (log scale) |
Components of the composite
- Benefit of SGLT2i consistent for stroke, heart failure (HF), all-cause death and end-stage renal disease (ESRD)
Timing of previous PCI
- Effects of SGLT2i consistent regardless of timing of previous PCI
Original publication
Cardiorenal outcomes and mortality after sodium‐glucose cotransporter‐2 inhibitor initiation in type 2 diabetes patients with percutaneous coronary intervention history. Diabetes Obes Metab. Published 21 April 2024. doi:10.
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