Diabetes, obesity & metabolism

Heart attack and stroke rates in people starting SGLT2-inhibitors compared to other diabetes medicines in real-world care

Updated

Abstract

The study included 205,160 patients and reported that initiation of sodium-glucose co-transporter-2 inhibitors (SGLT-2i) was associated with lower rates of myocardial infarction and stroke compared to other glucose-lowering drugs.

  • There were 1077 myocardial infarction events and 968 stroke events during the follow-up period.
  • Initiation of SGLT-2i was associated with a hazard ratio of 0.85 for myocardial infarction compared to other glucose-lowering drugs.
  • For stroke, the initiation of SGLT-2i was associated with a hazard ratio of 0.83.
  • Statistical significance was found for both outcomes, with P-values of .05 for myocardial infarction and .02 for stroke.
  • The findings support previous cardiovascular outcomes trials, indicating potential cardiovascular benefits of SGLT-2i.

Simplified

Key numbers

0.85
Lower Risk of Myocardial Infarction
Hazard ratio for MI in patients initiating SGLT-2i vs. oGLDs
0.83
Lower Risk of Stroke
Hazard ratio for stroke in patients initiating SGLT-2i vs. oGLDs
205160
205,160 Patients Analyzed
Total number of patients included in the analysis

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Funding

Competing interests

M. K. has received research grants from AstraZeneca and Boehringer Ingelheim; has served on advisory boards for AstraZeneca, Boehringer Ingelheim, Sanofi, Glytec, Novo Nordisk, ZS Pharma, Janssen, Merck (Diabetes) and Novartis; has served as a consultant for AstraZeneca, Boehringer Ingelheim, Sanofi, GSK, Janssen, Intarcia, Merck (Diabetes), Novo Nordisk, Glytec and ZS Pharma. K. I. B. has received grants to his institution from AstraZeneca for this study and fees for lectures and consulting from Novo Nordisk, Sanofi, Lilly, Boehringer Ingelheim and Merck Sharp & Dohme. M. A. C. has received personal fees from AstraZeneca, Merck, Sanofi‐Aventis, Chiesi and research support (non‐salary) from Abbott Laboratories, AstraZeneca, GlaxoSmithKline, The Medicines Company, Merck and Takeda. A. Z. F. has received grants from AstraZeneca and Merck and personal fees from Asclepius Analytics and Complete HEOR Solutions. J. P. W. has received lecture fees from Astellas, AstraZeneca, Boehringer Ingelheim, Janssen, Lilly, Novo Nordisk, Orexigen, Sanofi; has received consultancy (Institutional) fees from AstraZeneca, Boehringer Ingelheim, Janssen, Lilly and Orexigen; has received grants to his institution from Takeda, Novo Nordisk and AstraZeneca. K. K. has served as a consultant and speaker for AstraZeneca, Novartis, Novo Nordisk, Sanofi‐Aventis, Lilly, Merck Sharp & Dohme, Janssen and Boehringer Ingelheim; has received grants in support of investigator and investigator‐initiated trials from AstraZeneca, Novartis, Novo Nordisk, Sanofi‐Aventis, Lilly, Boehringer Ingelheim, Merck Sharp & Dohme and Roche; has served on advisory boards for Astra Zeneca, Novartis, Novo Nordisk, Sanofi‐Aventis, Lilly, Merck Sharp & Dohme, Janssen and Boehringer Ingelheim; is supported by the NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands (CLAHRC EM). R. W. H. has received grants from AstraZeneca. A. N. has received personal fees from AstraZeneca for this study and honoraria for lectures and advisory board meetings from Novo Nordisk, Boehringer Ingelheim and Lilly. M. E. J. is a shareholder in Novo Nordisk; was employed by Steno Diabetes Center A/S, a research hospital within the Danish National Health Service and owned by Novo Nordisk A/S, until December 31, 2016; and has received grants from AstraZeneca. M. T. is an employee of Statisticon, which was under contract with AstraZeneca for this study. J. B., E. T. W., N. H. and P. F. are employees of AstraZeneca.
PubMed

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