Cardiovascular Outcomes With Antidiabetic Drugs in People With Type 2 Diabetes and a Prior Stroke.

To assess the comparative effectiveness of sodium-glucose cotransporter 2 inhibitors (SGLT2i), thiazolidinediones (TZD), and dipeptidyl peptidase-4 inhibitors (DPP-4i) for the cardiorenal outcomes and mortality in individuals with type 2 diabetes and a prior stroke. Using the Korean National Health Insurance Service database from 2014 to 2021, a new-user cohort was established through propensity score matching for SGLT2i, TZD, and DPP-4i. The primary outcomes were major adverse cardiovascular events (MACE), comprising myocardial infarction, ischemic stroke, and cardiovascular death. Secondary outcomes included individual components of MACE, hospitalization for heart failure, a composite kidney outcome, and all-cause mortality. Weighted Cox proportional hazard models were used to calculate HRs and 95% CIs. Among 9733 participants (mean age, 67.2±3.2 years; 46.8% women), the incidence rate of MACE was 220, 202, and 251 per 1000 person-years for the SGLT2i, TZD, and DPP-4i groups. SGLT2i (HR, 0.86; 95% CI, 0.77 to 0.97; P=.01) and TZD (HR, 0.80; 95% CI, 0.70 to 0.90; P<.001) showed a lower risk of MACE compared to DPP-4i. Importantly, no significant difference in MACE was observed between SGLT2i and TZD. TZD was associated with a reduced risk of ischemic stroke, cardiovascular death, and the composite kidney outcome, whereas SGLT2i reduced risks of hospitalization for heart failure, the composite kidney outcome, and all-cause mortality compared to DPP-4i. SGLT2i and TZD use in people with type 2 diabetes and a prior stroke was associated with reduced risks of MACE, the composite kidney outcome, and mortality compared with DPP-4i, with variations in effects on individual outcomes.

Bae JH ，Choi J ，Kim NH ，Kim SG ... -  《-》

Comparing Effectiveness and Safety of SGLT2 Inhibitors vs DPP-4 Inhibitors in Patients With Type 2 Diabetes and Varying Baseline HbA1c Levels.

D'Andrea E ，Wexler DJ ，Kim SC ，Paik JM ，Alt E ，Patorno E ... -  《-》

Association of sodium-glucose cotransporter 2 inhibitors with risk of major adverse cardiovascular events in type 2 diabetes patients with acute coronary syndrome: a propensity score‑matched analysis.

This study aimed to investigate the association of sodium-glucose cotransporter 2 inhibitors (SGLT2i) use with cardiovascular (CV) clinical outcomes in type 2 diabetes (T2D) patients with acute coronary syndrome (ACS). Data of T2D patients hospitalized for ACS at Civil Aviation General Hospital from January 2019 to December 2022 were collected. Based on SGLT2i use or not, patients were stratified as SGLT2i group and SGLT2i-free group. A 1:1 nearest-neighbor propensity score-matched (PSM) was performed to adjust for the confounding factors and facilitate the robust comparisons between groups. The first occurrence of major adverse cardiovascular events (MACE) with 1 year follow-up, which consisted of CV death, all cause death, non-fatal myocardial infarction or stroke, coronary revascularization or heart failure readmission, was assessed. Kaplan-Meier analysis and Cox regressions were conducted to evaluate the prognostic significance of SGLT2i use. Subgroup analyses were performed to assess the interaction between subgroups and SGLT2i use. A total of 925 patients were included, and the SGLT2i use increased from 9.9% in 2019 to 43.8% in 2022. 226 pairs were finally matched using the PSM model. During 1 year follow-up period, a total of 110 patients experienced MACE in the matched cohort, with a rate of 24.3%. Survival analyses showed cumulative incidence of MACE, CV death, and heart failure readmission in the SGLT2i group were significantly lower than the SGLT2i-free group. Additionally, the adjusted Cox analyses demonstrated that SGLT2i was associated with a 34.1% lower risk of MACE (HR 0.659, 95% CI 0.487-0.892, P = 0.007), which was primarily driven by a decrease in the risk of CV death by 12.0% (HR 0.880, 95% CI 0.7830.990, P = 0.033), and heart failure readmission by 45.5% (HR 0.545, 95% CI 0.332-0.893, P = 0.016). This MACE preventive benefit was consistent across different subgroups (P interaction > 0.05 for all comparisons). In T2D patients with ACS, there was a clear increasing trend in SGLT2i use. SGLT2i was associated with a significantly lower risk of MACE, driven by the decrease in the risk of CV death, and heart failure readmission. Our study confirmed real-world use and efficacy of SGLT2i in a general T2D population with ACS.

Liu T ，Fan Z ，Xiao B ，He C ，Wang S ... -  《Cardiovascular Diabetology》

Comparative Effectiveness of Glucagon-Like Peptide-1 Receptor Agonists, Sodium-Glucose Cotransporter 2 Inhibitors, Dipeptidyl Peptidase-4 Inhibitors, and Sulfonylureas for Sight-Threatening Diabetic Retinopathy.

Barkmeier AJ ，Herrin J ，Swarna KS ，Deng Y ，Polley EC ，Umpierrez GE ，Galindo RJ ，Ross JS ，Mickelson MM ，McCoy RG ... -  《-》

GLP-1 Receptor Agonists and Risk for Cirrhosis and Related Complications in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease.

Kanwal F ，Kramer JR ，Li L ，Yang YX ，Cao Y ，Yu X ，Samuel R ，Ali B ，Desiderio R ，Cholankeril G ，Bajaj M ，El-Serag HB ，Asch SM ... -  《-》