Exploring the mortality and cardiovascular outcomes with SGLT-2 inhibitors in patients with T2DM at dialysis commencement: a health global federated network analysis
Main finding · MACEResult — go to the resultAdjusted hazard ratio 0.52Authors' conclusion
Our findings indicated a lower incidence of all-cause mortality and MACE after long-term follow-up, along with a higher likelihood of achieving dialysis-free status at 90 days in SGLT-2i users. Importantly, they underscored the potential cardiovascular protection and safety of SGLT-2is use in T2DM patients at the onset of dialysis.
Study context
- Population
- Patients with T2D initiating dialysis, TriNetX Research Network, January 1, 2012–January 1, 2024; SGLT-2i users age 63.3 ± 12.3 years, male 65.1%; non-users age 63.1 ± 12.9 years, male 65.8%matched cohort
- Participants
- 771 vs 771
- Exposure
- SGLT-2i users vs non-users
- SGLT-2i usersn = 771
- Non-usersn = 771reference
- Outcome
- Major adverse cardiac events (MACE) and all-cause mortality
- Follow-up
- Median 2.0 (IQR 0.3-3.9) years
Methodological detailsnew-user intention-to-treat design, propensity-score matched, TriNetX federated network EHR database
- New-user intention-to-treat design
- Propensity-score matched
- TriNetX federated network EHR database
Main finding
MACE · median follow-up 2.0 years
Adjusted hazard ratio
0.52
P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aHR | P value |
|---|---|---|
| All-cause mortality · median follow-up 2.0 yearsLower risk with SGLT-2i users | 0.49 | P < 0.001 |
| Dialysis-free status · 90 days after index dateSGLT-2i users more likely to become dialysis-free | 0.49 | P < 0.001 |
SGLT-2i use among patients initiating dialysis · within 3 months after dialysis
- Patients with T2D initiating dialysis using SGLT-2is (of 49,762)
- 1.57%
Safety
Ketoacidosis, urinary tract infection (UTI) or genital infection, hypoglycemia, dehydration, bone fractures, below-knee amputations, 90-day readmissions
- No significant differences in incidence
Original publication
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