CVD-REAL 2: SGLT-2 Inhibitors Associated With Lower Cardiovascular Risk Versus Other Glucose-Lowering Drugs

A large-scale, real-world study showed has shown that sodium glucose cotransporter-2 inhibitors (SGLT-2) inhibitors, compared with other glucose-lowering drugs (oGLD), were associated with a lower risk of a cardiovascular outcomes in patients with type 2 diabetes across six countries. The CVD-REAL 2 study was presented by Mikhail Kosiborod, MD, FACC, on Sunday, March 11 at ACC.18 in Orlando, FL. The results were simultaneously published in the Journal of the American College of Cardiology.

Using claims, medical records and national registries in South Korea, Japan, Singapore, Israel, Australia and Canada, new users of SGLT-2 inhibitors (n=235,064) and oGLDs (n=235,064) were identified, propensity-matched and included in the analysis. About 27 percent of patients had established cardiovascular disease.

The study evaluated the relationship between initiation of SGLT-2 inhibitors vs. oGLD and a broad range of cardiovascular outcomes – including the composite of all-cause death or hospitalization for heart failure (HHF), as well as all-cause death, HHF, myocardial infarction (MI) and stroke.

The results of the pooled analysis including all countries showed that SGLT-2 inhibitors were associated with a lower risk for all of the cardiovascular outcomes. Compared with the oGLDs, SGLT-2 inhibitors reduced the composite of all-cause death or HHF by 40 percent (9,788 events occurred). All-cause death was reduced by 49 percent and HHF was reduced by 36 percent. There was a 19 percent reduction in MIs (2,249 events) and a 32 percent reduction in strokes (6,439 events).

The direction of the results was consistent across the countries, and the results were stable in multiple sensitivity analyses and across patient subgroups. According to the researchers, the findings suggest that the cardiovascular benefits of SGLT-2 inhibitors may extend across patient ethnic and racial backgrounds and across the cardiovascular risk continuum.

Clinical Topics: Dyslipidemia, Heart Failure and Cardiomyopathies, Prevention, Lipid Metabolism, Acute Heart Failure

Keywords: ACC18, ACC Annual Scientific Session, Primary Prevention, Diabetes Mellitus, Type 2, Glucose, Propensity Score, Glucosides, Benzhydryl Compounds, Registries, Stroke, Heart Failure, Sodium-Glucose Transport Proteins, Hospitalization


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