Estimated glomerular filtration rate slope and risk of primary and secondary major adverse cardiovascular events and heart failure hospitalization in people with type 2 diabetes: An analysis of the Exenatide Study of Cardiovascular Event Lowering (EXSCEL) trial
Authors' conclusion
eGFR trajectories over time significantly predict incident MACE/hHF events in people with type 2 diabetes with and without existing CVD, with a higher hazard ratio for MACE/hHF in the latter group.
Study context
- Population
- People with T2D in the EXSCEL trial (once-weekly exenatide or placebo), primary and secondary cardiovascular disease (CVD) prevention settingsanalysed
- Participants
- 11,101 people
- Comparison
- 1-SD decrease in estimated glomerular filtration rate (eGFR) slope; participants without vs with previous CVD
- Without previous CVDn = 3,159
- With previous CVDn = 7,942
- Primary endpoint
- Association between eGFR slope and incidence of MACE/hHF (non-fatal MI, non-fatal stroke, CV death, or hospitalization for HF)
Methodological detailsBayesian joint modelling, adjusted for age, sex, smoking, systolic BP, baseline eGFR, antihypertensive and lipid-lowering medication, diabetes duration, AF, HDL-C, total cholesterol, HbA1c and treatment allocation
- Bayesian joint modelling
- Adjusted for age, sex, smoking, systolic BP, baseline eGFR, antihypertensive and lipid-lowering medication, diabetes duration, AF, HDL-C, total cholesterol, HbA1c and treatment allocation
Primary result
As reported in the abstract
MACE/hHF risk per 1-SD decrease in eGFR slope
Hazard ratio (95% CI)P value
Without previous CVDper 1-SD decrease in eGFR slope; increased risk of 48%
1.48(1.12–1.98)
P = 0.007With previous CVDper 1-SD decrease in eGFR slope; increased risk of 33%
1.33(1.18,1.51)
P < 0.001Per 1-SD decrease in eGFR slope, as printed
Further findings
Mean, mL/min/1.73 m²
| Outcome | Without previous CVD | With previous CVD |
|---|---|---|
| eGFR slope per year | −0.68 (SD 1.67) | −1.03 (SD 2.13) |
Original publication
Estimated glomerular filtration rate slope and risk of primary and secondary major adverse cardiovascular events and heart failure hospitalization in people with type 2 diabetes: An analysis of the EXSCEL trial. Diabetes Obes Metab. Published 31 July 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →