دورية أكاديمية
Better cardiovascular outcomes of type 2 diabetic patients treated with GLP-1 receptor agonists versus DPP-4 inhibitors in clinical practice
| العنوان: | Better cardiovascular outcomes of type 2 diabetic patients treated with GLP-1 receptor agonists versus DPP-4 inhibitors in clinical practice |
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| المؤلفون: | Longato E., Di Camillo B., Sparacino G., Tramontan L., Avogaro A., Fadini G. P. |
| المساهمون: | Longato, E., Di Camillo, B., Sparacino, G., Tramontan, L., Avogaro, A., Fadini, G. P. |
| بيانات النشر: | BioMed Central Ltd. |
| سنة النشر: | 2020 |
| المجموعة: | Padua Research Archive (IRIS - Università degli Studi di Padova) |
| مصطلحات موضوعية: | Drug therapy, Epidemiology, Observational, Registry, outcome, Aged, Cardiovascular Disease, Cause of Death, Databases, Factual, Diabetes Mellitus, Type 2, Dipeptidyl-Peptidase IV Inhibitor, Female, Glucagon-Like Peptide-1 Receptor, Human, Incretin, Italy, Male, Middle Aged, Patient Admission, Protective Factor, Retrospective Studie, Risk Assessment, Risk Factor, Time Factor, Treatment Outcome |
| الوصف: | Background: Cardiovascular outcome trials in high-risk patients showed that some GLP-1 receptor agonists (GLP-1RA), but not dipeptidyl-peptidase-4 inhibitors (DPP-4i), can prevent cardiovascular events in type 2 diabetes (T2D). Since no trial has directly compared these two classes of drugs, we performed a comparative outcome analysis using real-world data. Methods: From a database of ~ 5 million people from North-East Italy, we retrospectively identified initiators of GLP-1RA or DPP-4i from 2011 to 2018. We obtained two balanced cohorts by 1:1 propensity score matching. The primary outcome was the 3-point major adverse cardiovascular events (3P-MACE; a composite of death, myocardial infarction, or stroke). 3P-MACE components and hospitalization for heart failure were secondary outcomes. Results: From 330,193 individuals with T2D, we extracted two matched cohorts of 2807 GLP-1RA and 2807 DPP-4i initiators, followed for a median of 18 months. On average, patients were 63 years old, 60% male; 15% had pre-existing cardiovascular disease. The rate of 3P-MACE was lower in patients treated with GLP-1RA compared to DPP4i (23.5 vs. 34.9 events per 1000 person-years; HR: 0.67; 95% C.I. 0.53-0.86; p = 0.002). Rates of myocardial infarction (HR 0.67; 95% C.I. 0.50-0.91; p = 0.011) and all-cause death (HR 0.58; 95% C.I. 0.35-0.96; p = 0.034) were lower among GLP-1RA initiators. The as-treated and intention-to-treat approaches yielded similar results. Conclusions: Patients initiating a GLP-1RA in clinical practice had better cardiovascular outcomes than similar patients who initiated a DPP-4i. These data strongly confirm findings from cardiovascular outcome trials in a lower risk population. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/32522260; info:eu-repo/semantics/altIdentifier/wos/WOS:000542206200001; volume:19; issue:1; firstpage:74; journal:CARDIOVASCULAR DIABETOLOGY; http://hdl.handle.net/11577/3359189Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85086355760 |
| DOI: | 10.1186/s12933-020-01049-w |
| الإتاحة: | https://doi.org/10.1186/s12933-020-01049-wTest http://hdl.handle.net/11577/3359189Test |
| رقم الانضمام: | edsbas.80A85370 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s12933-020-01049-w |
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