Cardiovascular and renal outcomes with varying degrees of kidney disease in high-risk people with type 2 diabetes : An epidemiological analysis of data from the AMPLITUDE-O trial

© 2023 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd..

AIMS: To estimate the incidence of a major adverse cardiovascular event (MACE) and a composite kidney outcome across estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) levels, and to determine whether efpeglenatide's effect varies with these indices.

MATERIALS AND METHODS: AMPLITUDE-O trial data were used to estimate the relationship of eGFR, UACR, and Kidney Disease Improving Global Outcomes (KDIGO) category to the hazard of MACE and the kidney composite. Interactions on these outcomes between eGFR and the UACR, and between each of these variables and efpeglenatide were also assessed.

RESULTS: Baseline eGFR and UACR were available for 3983 participants (mean age 64.5 years). During a median follow-up of 1.8 years, the hazards of MACE and the kidney composite for the lowest versus highest eGFR third were 1.6 (95% confidence interval [CI] 1.2, 2.2) and 2.3 (95% CI 1.9, 2.8), respectively. The hazards for the highest versus the lowest UACR third were 2.3 (95% CI 1.8, 3.1) and 18.0 (95% CI 12.7, 25.5), respectively, and for the high- versus low-risk KDIGO categories the hazards were 2.4 (95% CI 1.8, 3.1) and 16.0 (95% CI 11.6, 22.0), respectively. eGFR and UACR were independent determinants of both outcomes, but negatively interacted with each other for the kidney outcome. Efpeglenatide's effect on both outcomes did not vary with any kidney disease measure (all interaction p values ≥0.26).

CONCLUSIONS: In high-risk people with diabetes, eGFR, UACR, and KDIGO category have different relationships to incident cardiovascular and kidney outcomes. The beneficial effect of efpeglenatide on these outcomes is independent of kidney-related risk category.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:26

Enthalten in:

Diabetes, obesity & metabolism - 26(2024), 4 vom: 13. März, Seite 1216-1223

Sprache:

Englisch

Beteiligte Personen:

Gerstein, Hertzel C [VerfasserIn]
Mian, Rajibul [VerfasserIn]
Ramasundarahettige, Chinthanie [VerfasserIn]
Branch, Kelley R H [VerfasserIn]
Del Prato, Stefano [VerfasserIn]
Lam, Carolyn S P [VerfasserIn]
Lopes, Renato D [VerfasserIn]
Pratley, Richard [VerfasserIn]
Rosenstock, Julio [VerfasserIn]
Sattar, Naveed [VerfasserIn]

Links:

Volltext

Themen:

AYI8EX34EU
Cardiovascular disease
Creatinine
GLP-1 analogue
Journal Article
Kidney disease
Randomized trial
Type 2 diabetes

Anmerkungen:

Date Completed 05.03.2024

Date Revised 05.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/dom.15417

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366073648