Cardiovascular and renal outcomes with canagliflozin according to baseline diuretic use: a post hoc analysis from the CANVAS Program.

Canagliflozin Cardiovascular System Diabetes Mellitus, Type 2 / complications Diuretics Female Humans Sodium-Glucose Transporter 2 Inhibitors
CANVAS Program Canagliflozin Diuretics Sodium-glucose cotransporter 2 inhibitor (SGLT2i)

Journal

ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191

Informations de publication

Date de publication:
04 2021
Historique:
revised: 09 12 2020
received: 29 09 2020
accepted: 19 01 2021
pubmed: 18 2 2021
medline: 2 7 2021
entrez: 17 2 2021
Statut: ppublish

Résumé

The CANVAS Program identified the effect of canagliflozin on major adverse cardiovascular events (MACE) differed according to whether participants were using diuretics at study commencement. We sought to further evaluate this finding related to baseline differences, treatment effects, safety, and risk factor changes. The CANVAS Program enrolled 10 142 participants with type 2 diabetes mellitus and high cardiovascular risk. Participants were randomized to canagliflozin or placebo and followed for a mean of 188 weeks. The primary outcome was major cardiovascular events, a composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Secondary outcomes included multiple cardiovascular, renal, and safety events. In this post hoc subgroup analysis, participants were categorized according to baseline use of any diuretic. The effect on outcomes was compared using Cox proportional hazards models, while risk factor changes were compared using mixed-effect models. At baseline, 4490 (44.3%) participants were using a diuretic. Compared with those not using a diuretic, participants using a diuretic were more likely to be older (mean age ± standard deviation, 64.3 ± 8.0 vs. 62.5 ± 8.3), be female (38.9% vs. 33.4%), and have heart failure (19.6% vs. 10.3%) (all P Participants on baseline diuretics derived a greater benefit for major cardiovascular events from canagliflozin, which was not fully explained by differences in participant characteristics nor risk factor changes.

Identifiants

DOI: 10.1002/ehf2.13236 PMID: 33595905 PMC: PMC8006652
pubmed: 33595905
doi: 10.1002/ehf2.13236
pmc: PMC8006652
doi:

Substances chimiques

Diuretics 0
Sodium-Glucose Transporter 2 Inhibitors 0
Canagliflozin 0SAC974Z85

Banques de données

ClinicalTrials.gov
['NCT01032629', 'NCT01989754']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1482-1493

Commentaires et corrections

Type : ErratumIn

Informations de copyright

© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

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Auteurs

Jie Yu (J)

The George Institute for Global Health, UNSW Sydney, Sydney, Australia.
Department of Cardiology, Peking University Third Hospital, Beijing, China.
Faculty of Medicine, University of New South Wales, Sydney, Sydney, Australia.

Clare Arnott (C)

The George Institute for Global Health, UNSW Sydney, Sydney, Australia.
Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
Sydney Medical School, University of Sydney, Sydney, Australia.
Faculty of Medicine, University of New South Wales, Sydney, Sydney, Australia.

Brendon L Neuen (BL)

The George Institute for Global Health, UNSW Sydney, Sydney, Australia.
Faculty of Medicine, University of New South Wales, Sydney, Sydney, Australia.

Hiddo L Heersprink (HL)

The George Institute for Global Health, UNSW Sydney, Sydney, Australia.
Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Kenneth W Mahaffey (KW)

Stanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.

Christopher P Cannon (CP)

Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.

Sadiya S Khan (SS)

Center for Global Cardiovascular Health, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 800, Chicago, IL, 60611, USA.

Abigail S Baldridge (AS)

Center for Global Cardiovascular Health, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 800, Chicago, IL, 60611, USA.

Sanjiv J Shah (SJ)

Center for Global Cardiovascular Health, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 800, Chicago, IL, 60611, USA.

Yuli Huang (Y)

The George Institute for Global Health, UNSW Sydney, Sydney, Australia.

Chao Li (C)

The George Institute for Global Health, UNSW Sydney, Sydney, Australia.

Gemma A Figtree (GA)

The George Institute for Global Health, UNSW Sydney, Sydney, Australia.
Sydney Medical School, University of Sydney, Sydney, Australia.
Kolling Institute, Royal North Shore Hospital and University of Sydney, Sydney, Australia.

Vlado Perkovic (V)

The George Institute for Global Health, UNSW Sydney, Sydney, Australia.
Faculty of Medicine, University of New South Wales, Sydney, Sydney, Australia.

Meg J Jardine (MJ)

The George Institute for Global Health, UNSW Sydney, Sydney, Australia.
Faculty of Medicine, University of New South Wales, Sydney, Sydney, Australia.

Bruce Neal (B)

The George Institute for Global Health, UNSW Sydney, Sydney, Australia.
The Charles Perkins Centre, University of Sydney, Sydney, Australia.
Faculty of Clinical Epidemiology, Imperial College London, London, UK.

Mark D Huffman (MD)

The George Institute for Global Health, UNSW Sydney, Sydney, Australia.
Center for Global Cardiovascular Health, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 800, Chicago, IL, 60611, USA.
ORCID: 0000-0001-7412-2519

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Classifications MeSH

Recherchemedicale.com › Glucides › Hétérosides › Glucosides › Canagliflozine › Cardiovascular and renal outcomes with...
Recherchemedicale.com › Système cardiovasculaire › Cardiovascular and renal outcomes with...
Recherchemedicale.com › Maladies endocriniennes › Diabète › Diabète de type 2 › Cardiovascular and renal outcomes with...
Recherchemedicale.com › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Diurétiques › Cardiovascular and renal outcomes with...
Recherchemedicale.com › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Cardiovascular and renal outcomes with...
Recherchemedicale.com › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Hypoglycémiants › Inhibiteurs du cotransporteur sodium-glucose de type 2 › Cardiovascular and renal outcomes with...