Sodium-glucose co-transporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors and the risk of heart failure: A nationwide cohort study of older adults with diabetes mellitus.
Aged
Cohort Studies
Diabetes Mellitus, Type 2
/ complications
Dipeptidyl-Peptidase IV Inhibitors
/ adverse effects
Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
Glucose
Heart Failure
/ epidemiology
Humans
Male
Ontario
/ epidemiology
Sodium
Sodium-Glucose Transporter 2 Inhibitors
/ adverse effects
Symporters
DPP-4 inhibitor
SGLT2 inhibitor
antidiabetic drug
cardiovascular disease
cohort study
heart failure
Journal
Diabetes, obesity & metabolism
ISSN: 1463-1326
Titre abrégé: Diabetes Obes Metab
Pays: England
ID NLM: 100883645
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
revised:
30
11
2020
received:
28
09
2020
accepted:
13
12
2020
pubmed:
19
12
2020
medline:
10
7
2021
entrez:
18
12
2020
Statut:
ppublish
Résumé
To analyse the rate of heart failure hospitalization for older adults prescribed a sodium-glucose co-transporter-2 (SGLT2) inhibitor. The study cohort included adults aged 66 years and older diagnosed with diabetes mellitus in Ontario, Canada, between July 2015 and March 2019, who received either an SGLT2 inhibitor or a dipeptidyl peptidase-4 (DPP-4) inhibitor. The primary outcome was a composite of heart failure hospitalization and all-cause mortality. Secondary outcomes included diabetic ketoacidosis and hypoglycaemia. A total of 29 916 adults prescribed an SGLT2 inhibitor were compared with 29 916 adults prescribed a DPP-4 inhibitor. The mean age was 72 years, 60% were men, the baseline glycated haemoglobin concentration was 8.2% and the baseline creatinine was 89 μmol/L. The incidence rate of the primary outcome was 19/1000 person-years for adults prescribed an SGLT2 inhibitor compared to 38/1000 person-years in those prescribed a DPP-4 inhibitor. This resulted in a hazard ratio (HR) of 0.49 (95% confidence interval [CI] 0.45, 0.54) and a rate difference (RD) of 19 fewer events per 1000 person-years (RD -19 [95% CI -22, -17]). Patients prescribed an SGLT2 inhibitor also had a lower rate of hypoglycaemia (HR 0.61 [95% CI 0.46, 0.81); RD -1.6 [95% CI -2.4, -0.8]), but a higher rate of diabetic ketoacidosis (HR 1.84 [95% CI 1.26, 2.70]; RD 1.0 [95% CI 0.4, 1.6]). Older adults prescribed an SGLT2 inhibitor had a lower rate of heart failure hospitalization or death, and a lower rate of hypoglycaemia, but an increased rate of diabetic ketoacidosis compared to older adults prescribed a DPP-4 inhibitor.
Substances chimiques
Dipeptidyl-Peptidase IV Inhibitors
0
Sodium-Glucose Transporter 2 Inhibitors
0
Symporters
0
Sodium
9NEZ333N27
Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
EC 3.4.14.-
Glucose
IY9XDZ35W2
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
950-960Informations de copyright
© 2020 John Wiley & Sons Ltd.
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