were associated with a significant reduction in hospitalization for heart failure risk among patients with type 2 diabetes without a cardiovascular disease history.
SGLT2 inhibitors were linked to a reduction in all-cause death risk compared to .
The composite risk of hospitalization for heart failure or all-cause death was also lower with SGLT2 inhibitors.
Significant risk reductions were observed in the full cohort, as well as in patients both with and without a cardiovascular disease history.
No significant reduction in hospitalization for heart failure was found in patients with a cardiovascular disease history.
Simplified
AIMS/INTRODUCTION: To evaluate the benefit of sodium-glucose cotransporter 2 inhibitors (SGLT2i) versus dipeptidyl peptidase-4 inhibitors (DPP4i) in reducing cardiovascular disease (CVD) events in patients with type 2 diabetes mellitus with and without a .
MATERIALS AND METHODS: This retrospective cohort study used Japanese hospital administrative data from the Medical Data Vision database (January 2015 to April 2020). Patients with type 2 diabetes mellitus (n = 625,739) who were new users of an SGLT2i (n = 57,070; 9.1%) or DPP4i (n = 568,669; 90.9%) were included. Outcomes included hospitalization for heart failure (hHF), all-cause death (ACD) and the composite of hHF or ACD. Hazard ratios (HR) were calculated using the inverse probability weighting Cox proportional hazards model to compare CVD event risks between treatment groups.
RESULTS: Compared with DPP4i, SGLT2i was associated with a significant reduction in hHF risk among patients without a CVD history (HR 0.507, 95% confidence interval 0.283-0.907), but not in the full cohort or those with a CVD history. SGLT2i was associated with a significant risk reduction of ACD (HR 0.592, 95% confidence interval 0.481-0.729) and the composite of hHF or ACD (HR 0.712, 95% confidence interval 0.613-0.826), compared with DPP4i in the full cohort; similar results were observed among patients with and without a CVD history.
CONCLUSIONS: In this real-world study, SGLT2i versus DPP4i was associated with a significant reduction in hHF, ACD and hHF or ACD events in patients with type 2 diabetes mellitus without a CVD history.
Key numbers
0.507
Reduction in heart failure hospitalization risk
Hazard ratio for hHF in patients without
0.592
Reduction in all-cause death risk
Hazard ratio for ACD in the full cohort
0.712
Reduction in composite risk of hHF or ACD
Hazard ratio for composite events in the full cohort
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