Sodium-Glucose Cotransporter 2 Inhibitors in South Australia: The Magic Before the Fame.
Heart failure
SGLT2i
Sodium-glucose cotransporter 2 inhibitor
South Australia
Journal
Heart, lung & circulation
ISSN: 1444-2892
Titre abrégé: Heart Lung Circ
Pays: Australia
ID NLM: 100963739
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
05
04
2023
revised:
07
08
2023
accepted:
17
08
2023
medline:
7
12
2023
pubmed:
2
11
2023
entrez:
1
11
2023
Statut:
ppublish
Résumé
Recent clinical trials have demonstrated that sodium-glucose cotransporter 2 inhibitors (SGLT2i), which were previously only indicated in treatment of type 2 diabetes mellitus (T2DM), can markedly reduce heart failure hospitalisation (HFH), with less striking potential reductions in acute coronary syndromes and cardiac arrhythmias. To evaluate the impact of SGLT2i on cardiovascular outcomes in real-world practice, we performed a retrospective cohort analysis on South Australian (SA) data. A total of 842 individuals with T2DM receiving SGLT2i were identified from SA public hospitals between 2011 and 2019. Episodes of care were temporally matched with those of 3,128 individuals with T2DM not receiving SGLT2i (control). Baseline characteristics were adjusted using inverse probability treatment weighting. The incidence of cardiovascular events at 12 and 24 months was evaluated using coded (International Classification of Diseases, Tenth Revision, Australian Modification [ICD-10-AM]) data. The primary outcome of HFH was lower with SGLT2i use at 12 months (adjusted hazard ratio [HR Use of SGLT2i in patients with T2DM in SA was associated with reductions in cardiovascular events even before their recent Pharmaceutical Benefits Scheme (PBS) listing for heart failure. Furthermore, this analysis supports that SGLT2i play a role not only in HFH reduction but also in reducing coronary and tachyarrhythmic events. This real-world evidence supports the use of SGLT2i as broadly protective cardiovascular drugs.
Sections du résumé
BACKGROUND
BACKGROUND
Recent clinical trials have demonstrated that sodium-glucose cotransporter 2 inhibitors (SGLT2i), which were previously only indicated in treatment of type 2 diabetes mellitus (T2DM), can markedly reduce heart failure hospitalisation (HFH), with less striking potential reductions in acute coronary syndromes and cardiac arrhythmias. To evaluate the impact of SGLT2i on cardiovascular outcomes in real-world practice, we performed a retrospective cohort analysis on South Australian (SA) data.
METHODS
METHODS
A total of 842 individuals with T2DM receiving SGLT2i were identified from SA public hospitals between 2011 and 2019. Episodes of care were temporally matched with those of 3,128 individuals with T2DM not receiving SGLT2i (control). Baseline characteristics were adjusted using inverse probability treatment weighting. The incidence of cardiovascular events at 12 and 24 months was evaluated using coded (International Classification of Diseases, Tenth Revision, Australian Modification [ICD-10-AM]) data.
RESULTS
RESULTS
The primary outcome of HFH was lower with SGLT2i use at 12 months (adjusted hazard ratio [HR
CONCLUSION
CONCLUSIONS
Use of SGLT2i in patients with T2DM in SA was associated with reductions in cardiovascular events even before their recent Pharmaceutical Benefits Scheme (PBS) listing for heart failure. Furthermore, this analysis supports that SGLT2i play a role not only in HFH reduction but also in reducing coronary and tachyarrhythmic events. This real-world evidence supports the use of SGLT2i as broadly protective cardiovascular drugs.
Identifiants
pubmed: 37914540
pii: S1443-9506(23)04315-9
doi: 10.1016/j.hlc.2023.08.011
pii:
doi:
Substances chimiques
Glucose
IY9XDZ35W2
Sodium
9NEZ333N27
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1369-1377Informations de copyright
Copyright © 2023 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest D.P.C. received institutional research funding from AstraZeneca. K.L. is involved in institutional research grants funded by AstraZeneca. E.S.G. was previously involved in institutional research grants funded by Bayer. C.G.D.P. reports research funding from AstraZeneca and Novartis, and consulting fees or speaker honoraria for AstraZeneca, Novartis, CSL Vifor, Boehringer Ingelheim, Bayer, Eli Lilly, and Roche Diagnostics. The remaining authors have no funding sources to report.