Real-Life Individual Comparison of Sodium-Glucose Cotransporter-2 Inhibitors in Patients with Heart Failure and Diabetes Mellitus

IF 2.8 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Mehmet Birhan Yilmaz, Ahmet Celik, Tugce Colluoglu, Anil Sahin, Dilek Ural, Arzu Kanik, Naim Ata, Mustafa Mahir Ulgu, Şuayip Birinci
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引用次数: 0

Abstract

Background

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are breakthrough agents for the treatment of type 2 diabetes mellitus (T2DM) and heart failure (HF). However, among patients with HF and T2DM, some uncertainty remains about individual comparisons, including dosing.

Objectives

We aimed to make a real-life individual comparison of SGLT2is among patients with HF and T2DM.

Methods

This was a subgroup analysis of the Turkish Ministry of Health’s National Electronic Database for adult patients with HF (TRends-HF). All-cause mortality (ACM) data up to 7 years were evaluated. Patients with HF and T2DM who were prescribed an SGLT2i were identified, and individual doses of empagliflozin 25 mg, empagliflozin 10 mg, and dapagliflozin 10 mg were compared. For individual comparisons, propensity score-matching analysis was generated as 1:1:1, and disease-modifying therapies (DMTs) for HF were considered.

Results

In the triple-matched cohort, 1-, 5-, and 7-year survival rates were 95%, 81%, and 76% versus 94%, 78%, and 72% versus 94%, 80%, and 75% for empagliflozin 25 mg, empagliflozin 10 mg, and dapagliflozin 10 mg, respectively. Among patients who were on triple DMT for HF, 1-, 5-, and 7-year survival rates were 95%, 78%, and 70% for empagliflozin 25 mg, 95%, 74%, and 66% for empagliflozin 10 mg, and 94%, 77%, and 69% for dapagliflozin, respectively. Annual emergency department visits were slightly lower with empagliflozin 10 mg and dapagliflozin 10 mg than with empagliflozin 25 mg. A greater proportion of patients on dapagliflozin 10 mg did not experience hospitalization during the 7-year follow-up compared with both doses of empagliflozin, albeit with a small effect size.

Conclusion

Among patients with HF and T2DM, SGLT2is are instrumental, and empagliflozin 10 mg remains significantly inferior to dapagliflozin 10 mg and empagliflozin 25 mg in terms of 5- and 7-year ACM.

钠-葡萄糖共转运蛋白-2抑制剂在心力衰竭和糖尿病患者中的个体比较
背景:钠-葡萄糖共转运蛋白-2抑制剂(SGLT2is)是治疗2型糖尿病(T2DM)和心力衰竭(HF)的突破性药物。然而,在HF和T2DM患者中,个体比较仍然存在一些不确定性,包括剂量。目的:我们旨在对HF和T2DM患者的SGLT2is进行现实生活中的个体比较。方法:这是土耳其卫生部成人心衰患者国家电子数据库(TRends-HF)的亚组分析。评估了长达7年的全因死亡率(ACM)数据。确定了处方SGLT2i的HF和T2DM患者,并比较了恩帕列净25mg、恩帕列净10mg和达格列净10mg的个体剂量。对于个体比较,倾向评分匹配分析为1:1:1,并考虑HF的疾病改善疗法(dmt)。结果:在三组配对队列中,恩帕列净25 mg、恩帕列净10 mg和达格列净10 mg组的1年、5年和7年生存率分别为95%、81%和76%,94%、78%和72%,94%、80%和75%。在接受三联DMT治疗HF的患者中,恩帕列净25 mg组的1年、5年和7年生存率分别为95%、78%和70%,恩帕列净10 mg组的95%、74%和66%,达格列净组的94%、77%和69%。恩帕列净10mg和达格列净10mg组的年度急诊访问量略低于恩帕列净25mg组。与两种剂量的恩帕格列净相比,服用达格列净10mg的患者在7年随访期间没有住院的比例更大,尽管效果较小。结论:在HF和T2DM患者中,SGLT2is是有帮助的,在5年和7年的ACM方面,恩格列净10mg仍然明显低于达格列净10mg和恩格列净25mg。
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来源期刊
CiteScore
6.70
自引率
3.30%
发文量
38
审稿时长
>12 weeks
期刊介绍: Promoting rational therapy within the discipline of cardiology, the American Journal of Cardiovascular Drugs covers all aspects of the treatment of cardiovascular disorders, particularly the place in therapy of newer and established agents. Via a program of reviews and original clinical research articles, the journal addresses major issues relating to treatment of these disorders, including the pharmacology, efficacy and adverse effects of the major classes of drugs; information on newly developed drugs and drug classes; the therapeutic implications of latest research into the aetiology of cardiovascular disorders; and the practical management of specific clinical situations. The American Journal of Cardiovascular Drugs offers a range of additional enhanced features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by a Key Points summary, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist patients, caregivers and others in understanding important medical advances. The journal also provides the option to include various other types of enhanced features including slide sets, videos and animations. All enhanced features are peer reviewed to the same high standard as the article itself. Peer review is conducted using Editorial Manager®, supported by a database of international experts. This database is shared with other Adis journals.
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