SGLT2i cuts cardiovascular, renal risk in diabetics

Compared with dipeptidyl peptidase-4 inhibitors (DPP4i), the use of sodium glucose co-transporter 2 inhibitors (SGLT2i) is associated with lower risk of cardiovascular disease, renal events, and heart failure (HF) hospitalization among patients with diabetes, reports a recent study.

Researchers retrospectively assessed 921 dapagliflozin- and 921 empagliflozin-treated patients, the outcomes of whom were compared against 1,842 comparators who received DPP4is. The primary endpoint was a composite of coronary events, a composite of ischaemic events, and a composite of heart failure and renal events. Analyses were propensity-score matched.

Over a median follow-up of 43.4 months, the composite coronary endpoint occurred in six patients (0.7 percent) in the dapagliflozin group, 10 patients (1.1 percent) in the empagliflozin group, and 55 patients (3.0 percent) in the DPP4i control group.

Multivariable analysis confirmed that SGLT2i use correlated with a lower incidence of composite coronary events (dapagliflozin: hazard ratio [HR], 0.267, 95 percent confidence interval [CI], 0.114–0.627; p=0.002; empagliflozin: HR, 0.467, 95 percent CI, 0.235–0.929; p=0.03).

The same was true for composite HF hospitalization and renal events, which arose in 0.4 percent, 0.9 percent, and 3.5 percent of the dapagliflozin, empagliflozin, and DPP4i groups, respectively.

Dapagliflozin (HR, 0.186, 95 percent CI, 0.067–0.519; p=0.001) and empagliflozin (HR, 0.358, 95 percent CI, 0.169–0.756; p=0.007) were likewise associated with significantly lower risks of HF hospitalization and renal events than the control.