Fenofibrate therapy and risk of heart failure outcomes in patients with type 2 diabetes: a propensity-matched cohort study.

IF 5.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal - Cardiovascular Pharmacotherapy Pub Date : 2025-07-21 DOI:10.1093/ehjcvp/pvaf053

Ji Yoon Kim, Nam Hoon Kim, Jiyoon Lee, Dong-Hoon Kim, Sin Gon Kim

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引用次数: 0

Abstract

Aims: This study investigated the association between fenofibrate use and outcomes of heart failure (HF) in patients with type 2 diabetes (T2D).

Methods and results: In a nationwide cohort database (2008-2022) in South Korea, patients with T2D (≥30 years) receiving statin therapy were 1:1 matched by propensity score into a statin plus fenofibrate group (n = 11,722) and statin only group (n = 11,722). The primary outcomes were hospitalisation for HF (HHF) and a composite of HHF or cardiovascular death. A Cox proportional hazards model was used to assess the association between treatments and outcomes. During a median of 50.4 months, the incidence rate per 1,000 person-years of HHF was 3.44 and 4.13 in the statin plus fenofibrate and statin only groups, respectively (adjusted hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.65-0.98). The adjusted HR for the composite outcome of HHF or cardiovascular death was 0.79 (95% CI, 0.65-0.96). Sensitivity analyses limited to individuals with ≥80% adherence showed consistent results (HHF: adjusted HR, 0.63; 95% CI, 0.43-0.92; composite outcome: adjusted HR, 0.68; 95% CI, 0.48-0.97).

Conclusions: In this propensity-weighted cohort study, the addition of fenofibrate to statins was associated with significantly lower risks of HHF and the composite outcome of HHF or cardiovascular death in patients with T2D, suggesting a novel cardiovascular benefit of fenofibrate.

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非诺贝特治疗和2型糖尿病患者心力衰竭结局的风险：一项倾向匹配的队列研究

目的：本研究探讨非诺贝特使用与2型糖尿病（T2D）患者心力衰竭（HF）结局之间的关系。方法和结果：在韩国的一个全国性队列数据库（2008-2022）中，接受他汀类药物治疗的T2D（≥30岁）患者按倾向评分1:1匹配，分为他汀类药物加非诺贝特组（n = 11,722）和他汀类药物单独组（n = 11,722）。主要结局是因心衰（HHF）住院以及HHF或心血管死亡的复合结局。采用Cox比例风险模型评估治疗与结果之间的关系。在50.4个月的中位数期间，他汀+非诺贝特组和仅他汀组的HHF发病率分别为每1000人年3.44和4.13(校正风险比[HR]， 0.80；95%可信区间[CI]， 0.65-0.98)。HHF或心血管死亡复合结局的校正HR为0.79 （95% CI, 0.65-0.96）。敏感性分析仅限于依从性≥80%的个体，结果一致(HHF：调整HR， 0.63；95% ci, 0.43-0.92；综合结局：调整后HR为0.68；95% ci, 0.48-0.97)。结论：在这项倾向加权队列研究中，非诺贝特加入他汀类药物与T2D患者HHF风险和HHF或心血管死亡的复合结局显著降低相关，表明非诺贝特对心血管有新的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Heart Journal - Cardiovascular Pharmacotherapy Medicine-Cardiology and Cardiovascular Medicine

CiteScore

10.10

自引率

14.10%

发文量

期刊介绍： The European Heart Journal - Cardiovascular Pharmacotherapy (EHJ-CVP) is an international, peer-reviewed journal published in English, specifically dedicated to clinical cardiovascular pharmacology. EHJ-CVP publishes original articles focusing on clinical research involving both new and established drugs and methods, along with meta-analyses and topical reviews. The journal's primary aim is to enhance the pharmacological treatment of patients with cardiovascular disease by interpreting and integrating new scientific developments in this field. While the emphasis is on clinical topics, EHJ-CVP also considers basic research articles from fields such as physiology and molecular biology that contribute to the understanding of cardiovascular drug therapy. These may include articles related to new drug development and evaluation, the physiological and pharmacological basis of drug action, metabolism, drug interactions, and side effects.