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- Title
All-Cause Mortality in Patients With Diabetes Under Treatment With Dapagliflozin: A Population-Based, Open-Cohort Study in The Health Improvement Network Database.
- Authors
Toulis, Konstantinos A; Willis, Brian H; Marshall, Tom; Kumarendran, Balachadran; Gokhale, Krishna; Ghosh, Sandip; Thomas, G Neil; Cheng, Kar Keung; Narendran, Parth; Hanif, Wasim; Nirantharakumar, Krishnarajah
- Abstract
<bold>Context: </bold>Empagliflozin was found to decrease mortality in patients with type 2 diabetes mellitus (T2DM) and a prior cardiovascular disease (CVD) event.<bold>Objectives: </bold>To establish whether these benefits can be replicated in a real-world setting, should be expected with the use of dapagliflozin, and apply to T2DM patients at low risk of CVD.<bold>Design: </bold>General practice, population-based, retrospective cohort study (January 2013 to September 2015).<bold>Setting: </bold>The Health Improvement Network database.<bold>Participants: </bold>A total of 22,124 T2DM patients (4444 exposed to dapagliflozin; 17,680 unexposed T2DM patients) matched for age, sex, body mass index, T2DM duration, and smoking.<bold>Main Outcome Measures: </bold>The primary outcome was all-cause mortality (high and low risk for CVD) in the total study population, expressed as the adjusted incidence rate ratio (aIRR) with 95% confidence intervals (CIs). As a secondary analysis in the low-risk population, all-cause mortality and incident CVD were considered.<bold>Results: </bold>Patients with T2DM exposed to dapagliflozin were significantly less likely to die of any cause (aIRR: 0.50; 95% CI: 0.33 to 0.75; P = 0.001). Similarly, in low-risk patients, death from any cause was significantly lower in the cohort exposed to dapagliflozin (aIRR: 0.44; 95% CI: 0.25 to 0.78; P = 0.002). The difference in the risk of incident CVD did not reach statistical significance between groups in low-risk patients (aIRR: 0.89; 95% CI: 0.61 to 1.31; P = 0.546).<bold>Conclusions: </bold>Patients with T2DM who were exposed to dapagliflozin had a lower risk of death from any cause irrespective of baseline CVD status.
- Subjects
HYPOGLYCEMIC agents; GLYCOSIDES; BENZENE; HEART ventricle diseases; CARDIOVASCULAR diseases; CORONARY disease; DATABASES; CAUSES of death; LEFT heart ventricle; HEART failure; LONGITUDINAL method; MORTALITY; MYOCARDIAL infarction; TYPE 2 diabetes; STROKE; TRANSIENT ischemic attack; RETROSPECTIVE studies; CASE-control method; THERAPEUTICS
- Publication
Journal of Clinical Endocrinology & Metabolism, 2017, pN.PAG
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2016-3446