Sodium-Glucose Cotransporter 2 Inhibitors Reduce the Risk of Hospitalization for Heart Failure and Amputation Rate Compared With Incretin-Based Therapy in Patients With Diabetic Foot Disease : A Nationwide Population-Based Study
Copyright © 2024 AACE. Published by Elsevier Inc. All rights reserved..
OBJECTIVE: Major adverse cardiovascular event (MACE) outcomes associated with sodium-glucose cotransporter 2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapies remain unclear in patients with type 2 diabetes and newly diagnosed diabetic foot complications (DFCs). This study examined the impact of SGLT2i and GLP-1 RA use on the rates of MACEs and amputations in patients with type 2 diabetes and without cardiovascular disease.
METHODS: Data from the Taiwan National Health Insurance Research Database (2004-2017) were analyzed, focusing on patients with type 2 diabetes without previous MACE and newly diagnosed DFCs. The primary outcome was the first MACE occurrence, and the secondary outcomes included MACE components, all-cause mortality, and lower extremity amputation (LEA) rates.
RESULTS: SGLT2i users showed a significant decrease in the MACE (hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.46-0.88) and hospitalization for heart failure (HR, 0.54; 95% CI, 0.35-0.83) rates compared with dipeptidyl peptidase-4 inhibitor users. The amputation rates were also lower in SGLT2i users without LEA at the first DFC diagnosis (HR, 0.28; 95% CI, 0.10-0.75) and did not increase in those with a history of peripheral artery disease or LEA. No significant differences were observed between dipeptidyl peptidase-4 inhibitor and GLP-1 RA users in terms of the primary or secondary outcomes.
CONCLUSION: In patients with type 2 diabetes initially diagnosed with DFC, SGLT2i are effective in significantly reducing the hospitalization for heart failure and MACE rates. SGLT2i lower the amputation rates, especially in patients who have not previously had a LEA, than the dipeptidyl peptidase-4 inhibitor therapy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists - (2024) vom: 05. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lin, Yi-Hsuan [VerfasserIn] |
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| Links: |
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| Themen: |
Amputation rate |
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| Anmerkungen: |
Date Revised 25.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.eprac.2024.01.016 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368148661 |
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| 100 | 1 | |a Lin, Yi-Hsuan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Sodium-Glucose Cotransporter 2 Inhibitors Reduce the Risk of Hospitalization for Heart Failure and Amputation Rate Compared With Incretin-Based Therapy in Patients With Diabetic Foot Disease |b A Nationwide Population-Based Study |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 25.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 AACE. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: Major adverse cardiovascular event (MACE) outcomes associated with sodium-glucose cotransporter 2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapies remain unclear in patients with type 2 diabetes and newly diagnosed diabetic foot complications (DFCs). This study examined the impact of SGLT2i and GLP-1 RA use on the rates of MACEs and amputations in patients with type 2 diabetes and without cardiovascular disease | ||
| 520 | |a METHODS: Data from the Taiwan National Health Insurance Research Database (2004-2017) were analyzed, focusing on patients with type 2 diabetes without previous MACE and newly diagnosed DFCs. The primary outcome was the first MACE occurrence, and the secondary outcomes included MACE components, all-cause mortality, and lower extremity amputation (LEA) rates | ||
| 520 | |a RESULTS: SGLT2i users showed a significant decrease in the MACE (hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.46-0.88) and hospitalization for heart failure (HR, 0.54; 95% CI, 0.35-0.83) rates compared with dipeptidyl peptidase-4 inhibitor users. The amputation rates were also lower in SGLT2i users without LEA at the first DFC diagnosis (HR, 0.28; 95% CI, 0.10-0.75) and did not increase in those with a history of peripheral artery disease or LEA. No significant differences were observed between dipeptidyl peptidase-4 inhibitor and GLP-1 RA users in terms of the primary or secondary outcomes | ||
| 520 | |a CONCLUSION: In patients with type 2 diabetes initially diagnosed with DFC, SGLT2i are effective in significantly reducing the hospitalization for heart failure and MACE rates. SGLT2i lower the amputation rates, especially in patients who have not previously had a LEA, than the dipeptidyl peptidase-4 inhibitor therapy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a GLP-1 receptor agonist | |
| 650 | 4 | |a SGLT2 inhibitors | |
| 650 | 4 | |a amputation rate | |
| 650 | 4 | |a diabetic foot complications | |
| 650 | 4 | |a major adverse cardiovascular events | |
| 650 | 4 | |a type 2 diabetes mellitus | |
| 700 | 1 | |a Lin, Chia-Hung |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Yu-Chih |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Yu-Yao |e verfasserin |4 aut | |
| 700 | 1 | |a Tai, An-Shun |e verfasserin |4 aut | |
| 700 | 1 | |a Fu, Shih-Chen |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Sheng-Hsuan |e verfasserin |4 aut | |
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