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Association between sodium glucose co-transporter 2 inhibitors and a reduced risk of heart failure in patients with type 2 diabetes mellitus: a real-world nationwide population-based cohort study

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dc.contributor.authorKim, YG-
dc.contributor.authorHan, SJ-
dc.contributor.authorKim, DJ-
dc.contributor.authorLee, KW-
dc.contributor.authorKim, HJ-
dc.date.accessioned2019-11-13T00:18:19Z-
dc.date.available2019-11-13T00:18:19Z-
dc.date.issued2018-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/16955-
dc.description.abstractBACKGROUND: Recently, two large randomized controlled trials which only included patients with underlying cardiovascular disease (CVD) or patients at high risk for CVD showed that two sodium glucose co-transporter 2 inhibitors (SGLT-2is) significantly reduced hospitalization for heart failure (hHF), with an early separation in the survival curves for hHF. There were concerns whether SGLT-2i use could protect hHF in patients without CVD and how soon SGLT-2i-treated patients show a lower risk of hHF. Thus, we aimed to evaluate whether the heart failure protective effect of SGLT-2i differs depending on the underlying CVD and the prescription period compared with dipeptidyl peptidase-4 inhibitors (DPP-4i).
METHODS: We performed a nationwide retrospective observational study to estimate the effect of SGLT-2i on HF. The 59,479 SGLT-2i new-users were matched with same number of DPP-4i new-users through propensity score matching using 53 confounding variables. Kaplan-Meier (K-M) curves and Cox proportional hazards regression analyses were used to estimate the risk of hospitalization for hHF.
RESULTS: The incidence rates of hHF were 0.83 and 1.13 per 100 person-years in SGLT-2i-treated patients and DPP-4i-treated patients, respectively. The hazard ratios of hHF were 0.66 (95% confidence interval 0.58-0.75) in SGLT-2i-treated patients compared with the DPP-4i-treated patients. Among the patients with underlying CVD, SGLT-2i-treated patients were associated with a lower risk of hHF from 30 days to 3 years after initiating drugs compared with DPP-4i. However, SGLT-2i use only showed a lower risk of hHF with a significant difference 3 years after drug initiation among patients without underlying CVD.
CONCLUSIONS: Our findings suggest that SGLT-2i reduced hHF compared with DPP-4i. A heart failure protective effect of SGLT-2i use vs. DPP-4i use was shown 30 days after initiating the SGLT-2i among patients with established CVD, but this effect appeared later in patients without established CVD.
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dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHDiabetes Mellitus, Type 2-
dc.subject.MESHDipeptidyl-Peptidase IV Inhibitors-
dc.subject.MESHFemale-
dc.subject.MESHHeart Failure-
dc.subject.MESHHumans-
dc.subject.MESHIncidence-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHProtective Factors-
dc.subject.MESHRepublic of Korea-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Assessment-
dc.subject.MESHRisk Factors-
dc.subject.MESHSodium-Glucose Transporter 2 Inhibitors-
dc.subject.MESHTime Factors-
dc.subject.MESHTreatment Outcome-
dc.titleAssociation between sodium glucose co-transporter 2 inhibitors and a reduced risk of heart failure in patients with type 2 diabetes mellitus: a real-world nationwide population-based cohort study-
dc.typeArticle-
dc.identifier.pmid29935543-
dc.identifier.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015464/-
dc.subject.keywordHeart failure-
dc.subject.keywordType 2 diabetes mellitus-
dc.subject.keywordSodium glucose co-transporter 2 inhibitors dipeptidyl peptidase-4 inhibitor-
dc.contributor.affiliatedAuthor한, 승진-
dc.contributor.affiliatedAuthor김, 대중-
dc.contributor.affiliatedAuthor이, 관우-
dc.contributor.affiliatedAuthor김, 혜진-
dc.type.localJournal Papers-
dc.identifier.doi10.1186/s12933-018-0737-5-
dc.citation.titleCardiovascular diabetology-
dc.citation.volume17-
dc.citation.number1-
dc.citation.date2018-
dc.citation.startPage91-
dc.citation.endPage91-
dc.identifier.bibliographicCitationCardiovascular diabetology, 17(1). : 91-91, 2018-
dc.identifier.eissn1475-2840-
dc.relation.journalidJ014752840-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Endocrinology & Metabolism
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