Cardiovascular Risks With SGLT2 Inhibitors in Clinical Practice Among Patients With Type 2 Diabetes
Main finding · Total CVDResult — go to the resultHazard ratio 0.82 95% CI 0.69–0.98Authors' conclusion
In this cohort study of patients with T2D, the use of SGLT2is vs DPP4is was associated with reduced total cardiovascular burden, suggesting that long-term use of this therapy may optimize treatment benefit among patients with chronic CVD. The SGLT2i-associated benefit among patients with high risk of CVD encourages the prioritization of SGLT2i use for these vulnerable individuals.
Study context
- Population
- Adults with T2D initiating first use of study drugs 2016–2019, National Cheng Kung University Hospital, Taiwan; up to 6 years of follow-up
- Participants
- 8,384 adults1,632 matched pairs
- Exposure
- SGLT2i vs DPP4i therapy
- SGLT2in = 1,632
- DPP4in = 1,632reference
- Outcome
- Total (first and subsequent) composite CVD events and individual CVD subtypes (AF, coronary heart disease, HF, stroke, MI, transient ischemic attack)
Methodological detailspropensity score-matched, single-centre electronic medical records, shared frailty model
- Propensity score-matched
- Single-centre electronic medical records
- Shared frailty model
Main finding
Total CVD
Hazard ratio
0.82
95% CI 0.69–0.98
SGLT2ivs DPP4i
HR 0.82 (95% CI 0.69–0.98)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Total CVD, eGFR <60 mL/min/1.73 m² | 0.70 (0.62–0.80) | |
| Total CVD, any diabetes-related complications | 0.70 (0.64–0.78) | |
| Total CVD, history of CVD | 0.72 (0.65–0.80) | |
| 0.512Hazard ratio (log scale) |
| Outcome | HR (95% CI) |
|---|---|
| Total CVD, women with history of CVD | 0.59 (0.49–0.72) |
Total cardiovascular disease (CVD), women with history of CVD
- Greater reduction in total CVD burden with SGLT2i in women vs men at high CVD risk
Original publication
Cardiovascular Risks With SGLT2 Inhibitors in Clinical Practice Among Patients With Type 2 Diabetes. JAMA Netw Open. Published 1 October 2024. doi:10.
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