دورية أكاديمية
SGLT2 Inhibitors vs GLP-1 Receptor Agonists and Clinical Outcomes in Patients With Diabetes With/Without Atrial Fibrillation.
| العنوان: | SGLT2 Inhibitors vs GLP-1 Receptor Agonists and Clinical Outcomes in Patients With Diabetes With/Without Atrial Fibrillation. |
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| المؤلفون: | Chan YH; The Cardiovascular Department, Chang Gung Memorial Hospital at Linkou, Taoyuan City 333, Taiwan.; College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan.; School of Traditional Chinese Medicine, College of Medicine, Chang-Gung University, Taoyuan City 333, Taiwan.; Microscopy Core Laboratory, Chang Gung Memorial Hospital at Linkou, Taoyuan City 333, Taiwan., Chao TF; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.; Institute of Clinical Medicine, Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan., Chen SW; College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan.; Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City 333, Taiwan., Lee HF; College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan.; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan.; Division of Cardiology, Department of Medicine, New Taipei City Municipal Tucheng Hospital (Chang Gung Memorial Hospital, Tucheng Branch, Taiwan), New Taipei City 236, Taiwan., Li PR; Department of Public Health, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan., Yeh YH; The Cardiovascular Department, Chang Gung Memorial Hospital at Linkou, Taoyuan City 333, Taiwan.; College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan., Kuo CT; The Cardiovascular Department, Chang Gung Memorial Hospital at Linkou, Taoyuan City 333, Taiwan.; College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan., See LC; Department of Public Health, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan.; Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan City 333, Taiwan.; Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan City 333, Taiwan., Lip GYH; Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L69 3BX, UK.; Department of Clinical Medicine, Aalborg University, Aalborg 9000, Denmark. |
| المصدر: | The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2024 Sep 16; Vol. 109 (10), pp. 2617-2629. |
| نوع المنشور: | Journal Article; Comparative Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 0375362 Publication Model: Print Cited Medium: Internet ISSN: 1945-7197 (Electronic) Linking ISSN: 0021972X NLM ISO Abbreviation: J Clin Endocrinol Metab Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2017- : New York : Oxford University Press Original Publication: Springfield, Ill. : Charles C. Thomas |
| مواضيع طبية MeSH: | Diabetes Mellitus, Type 2*/drug therapy , Diabetes Mellitus, Type 2*/complications , Sodium-Glucose Transporter 2 Inhibitors*/therapeutic use , Atrial Fibrillation*/drug therapy , Atrial Fibrillation*/epidemiology , Glucagon-Like Peptide-1 Receptor*/agonists, Humans ; Male ; Female ; Retrospective Studies ; Aged ; Middle Aged ; Taiwan/epidemiology ; Treatment Outcome ; Incidence ; Hypoglycemic Agents/therapeutic use ; Follow-Up Studies ; Heart Failure/epidemiology ; Heart Failure/drug therapy ; Adult ; Glucagon-Like Peptide-1 Receptor Agonists |
| مستخلص: | Context: The coexistence of diabetes mellitus and atrial fibrillation (AF) is associated with substantial risks of adverse cardiovascular events. Objective: The relevant outcomes associated with the use of a sodium-glucose cotransporter-2 inhibitor (SGLT2i) vs glucagon-like peptide-1 receptor agonists (GLP-1RAs) among patients with type 2 diabetes (T2D) with/without concomitant AF remain unknown. Methods: In this nationwide retrospective cohort study from the Taiwan National Health Insurance Research Database, there were 344 392 and 31 351 patients with T2D without AF, and 11 462 and 816 T2D patients with AF treated with SGLT2is and GLP-1RAs, respectively, from May 1, 2016, to December 31, 2019. Patients were followed from the drug index date until the occurrence of study events, discontinuation of the index drug, or the end of the study period (December 31, 2020), whichever occurred first. We used propensity score-stabilized weight to balance covariates across the 2 medication groups. Results: The incidence rate of all study outcomes in patients with concomitant AF was much higher than in those without concomitant AF. For the AF cohort, SGLT2i vs GLP-1RA was associated with a lower risk of hospitalization for heart failure (HF) (2.32 vs 4.74 events per 100 person-years; hazard ratio [HR] 0.48, 95% CI 0.36-0.66), with no benefit seen for the non-AF cohort (P for homogeneity < .01). SGLT2i vs GLP-1RA was associated with a lower risk of composite kidney outcomes both in the AF (0.38 vs 0.79 events per 100 person-years; HR 0.47; 95% CI 0.23-0.96) and the non-AF cohorts (0.09 vs 0.18 events per 100 person-years; HR 0.53; 95% CI 0.43-0.64). There were no significant differences in the risk of major adverse cardiovascular events and all-cause mortality in those who received SGLT2i compared with GLP-1RA for the AF or non-AF cohorts. Conclusion: Considering the high risk of developing HF and/or high prevalence of concomitant HF in patients with concomitant diabetes and AF, whether SGLT2is should be the preferred treatment to GLP-1RAs for such a high-risk population requires further investigation. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| معلومات مُعتمدة: | CMRPG3J1371 Ministry of Science and Technology, Taiwan; Chang Gung Memorial Hospital, Linkou |
| فهرسة مساهمة: | Keywords: atrial fibrillation; composite kidney outcomes; glucagon-like peptide-1 receptor agonist; heart failure; sodium-glucose cotransporter-2 inhibitor; type 2 diabetes |
| المشرفين على المادة: | 0 (Sodium-Glucose Transporter 2 Inhibitors) 0 (Glucagon-Like Peptide-1 Receptor) 0 (Hypoglycemic Agents) 0 (Glucagon-Like Peptide-1 Receptor Agonists) |
| تواريخ الأحداث: | Date Created: 20240311 Date Completed: 20240916 Latest Revision: 20240916 |
| رمز التحديث: | 20240916 |
| DOI: | 10.1210/clinem/dgae157 |
| PMID: | 38466894 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1945-7197 |
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| DOI: | 10.1210/clinem/dgae157 |