Cardiorenal protective effects of anti-diabetic drugs in early stage Cardiovascular-Kidney-Metabolic Syndrome: A multicenter, time-varying analysis
Authors' conclusion
In early CKM, most ADAs reduce cardiovascular risk, but SGLT2 inhibitors provide superior renal protection and survival benefits.
Study context
- Population
- Adults with newly diagnosed diabetes initiating antidiabetic agents (ADAs) 2016–2019 (early cardiovascular-kidney-metabolic (CKM)), Taipei Medical University Clinical Research Database; mean age 61 years
- Participants
- 18,467 adults
- Exposure
- Eight ADA classes vs non-use and vs SGLT2i
- Outcome
- Stroke, AMI, ESRD and all-cause mortality
Methodological detailsmulticenter, time-varying Cox proportional hazards models
- Multicenter
- Time-varying Cox proportional hazards models
Main finding
As reported in the abstract
Adjusted hazard ratio
1.65
stroke
Adjusted hazard ratio
2.47
Acute myocardial infarction (AMI)
- End-stage renal disease (ESRD) risk, other ADAs vs SGLT2i (aHR range)
- 3.62-19.16
- All-cause mortality, other ADAs vs SGLT2i (aHR range)
- 5.80-66.84
Observational data: associations, not effects.
Further findings
ESRD risk without SGLT2i, subgroups
- Absence of SGLT2i associated with greater ESRD risk in younger and obese patients
Original publication
Cardiorenal protective effects of anti-diabetic drugs in early stage Cardiovascular-Kidney-Metabolic Syndrome: A multicenter, time-varying analysis. Diabetes Res Clin Pract. Published 4 April 2026. doi:10.
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