Background: In patients with type 2 diabetes mellitus (T2DM), a history of an ischemic event is associated with increased risk for cardiovascular (CV) disease. Whether patients with T2DM and a recent atherothrombotic diagnosis benefit from early intervention with a sodium-glucose co-transporter 2 inhibitor is unknown.
Methods: This study is a secondary analysis of the gliflozin Cardiovascular Event Trial in Type 2 Diabetes Mellitus Patients-emoving xcess lucose (EMPA-REG OUTCOME), which compared empagliflozin to placebo in adults with T2DM and atherosclerotic CV disease (ASCVD). Participants were categorized based on the time since their last qualifying ASCVD diagnosis (≤ 1 year vs > 1 year). Qualifying ASCVD diagnoses included ischemic or hemorrhagic stroke, myocardial infarction, coronary artery disease, and peripheral artery disease. The primary outcome was a composite of CV death, nonfatal myocardial infarction, or nonfatal stroke.
Results: A total of 6796 participants (n = 4547 empagliflozin, n = 2249 placebo) were included. Median time since the last qualifying ASCVD diagnosis was 3.8 years (quartile 1-quartile 3: 1.5-7.6), and most qualifying diagnoses occurred > 1 year before randomization (≤ 1 year, n = 1214; > 1 year, n = 5582). Empagliflozin reduced the incidence of the primary outcome irrespective of the time since the last qualifying ASCVD diagnosis (≤ 1 year: hazard ratio 0.82, 95% confidence interval: 0.57-1.16; vs > 1 year: hazard ratio 0.85, 95% confidence interval: 0.72-1.00; for interaction = 0.84). Results were similar for the composite of CV death or hospitalization for heart failure.
Conclusions: Empagliflozin improved CV outcomes in participants with T2DM, irrespective of the time since the last qualifying ASCVD diagnosis at randomization. Prospective trials are necessary to investigate the use of sodium-glucose co-transporter 2 inhibitors at the time of an acute ASCVD event.
Trial Registration: EMPA-REG OUTCOME (Clinicaltrials.gov identifier: NCT01131676).
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11252526 | PMC |
| http://dx.doi.org/10.1016/j.cjco.2024.01.013 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Learning health system linchpins: information exchange and a common data model.
J Am Med Inform Assoc
January 2025
Center for Biomedical Informatics, Brown University, Providence, RI 02912, United States.
Objective: To demonstrate the potential for a centrally managed health information exchange standardized to a common data model (HIE-CDM) to facilitate semantic data flow needed to support a learning health system (LHS).
Materials And Methods: The Rhode Island Quality Institute operates the Rhode Island (RI) statewide HIE, which aggregates RI health data for more than half of the state's population from 47 data partners. We standardized HIE data to the Observational Medical Outcomes Partnership (OMOP) CDM.
Factors associated with lipid lowering therapy in the multi-ethnic study of atherosclerosis.
Lipids Health Dis
November 2024
Department of Laboratory Medicine and Pathology, University of Minnesota, Twin Cities, MN, USA.
Article Synopsis
- Lipid-lowering therapy (LLT) is crucial for managing atherosclerotic cardiovascular disease (ASCVD) risk, but it is underused by over 40% of eligible individuals in the U.S.
- A study analyzed data from the Multi-Ethnic Study of Atherosclerosis (MESA) to understand the demographics and health conditions influencing LLT usage between 2010-2012 and 2016-2018.
- Findings revealed that Black participants were less likely to be on LLT, while higher body mass index (BMI) and the presence of coronary artery calcium (CAC) were strongly associated with LLT use, indicating healthcare disparities and the importance of CAC measurement.
Comparison of pooled cohort equation and PREVENT™ risk calculator for statin treatment allocation.
Atherosclerosis
December 2024
Jersey Shore University Medical Center, Department of Cardiology, 1945 NJ-33, Neptune City, NJ, 07753, USA.
Background And Aims: Effective hypercholesterolemia management is linked to lower all-cause and cardiovascular mortality. The 2018 AHA/ACC guidelines recommended using the Pooled Cohort Equations (PCE) for lipid management, but these may overestimate risk and be less accurate for certain racial groups. The AHA's new PREVENT equation, which omits race and includes cardiometabolic factors, aims to provide a more accurate risk assessment for a diverse population.
View Article and Find Full Text PDFEffect of Qualifying Atherosclerotic Cardiovascular Disease Diagnosis Proximity on Cardiovascular Risk and Benefit of Empagliflozin in the EMPA-REG OUTCOME Trial.
CJC Open
July 2024
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Background: In patients with type 2 diabetes mellitus (T2DM), a history of an ischemic event is associated with increased risk for cardiovascular (CV) disease. Whether patients with T2DM and a recent atherothrombotic diagnosis benefit from early intervention with a sodium-glucose co-transporter 2 inhibitor is unknown.
Methods: This study is a secondary analysis of the gliflozin Cardiovascular Event Trial in Type 2 Diabetes Mellitus Patients-emoving xcess lucose (EMPA-REG OUTCOME), which compared empagliflozin to placebo in adults with T2DM and atherosclerotic CV disease (ASCVD).
Estimated impact of guidelines-based initiation of dual antihypertensive therapy on long-term cardiovascular outcomes in 1.1 million individuals.
Eur Heart J Cardiovasc Pharmacother
July 2024
Sanofi, Dubai, United Arab Emirates.
Aims: Guidelines recommend initiation of dual combination antihypertensive therapy, preferably single-pill combination (SPC), in most patients with hypertension. Evidence on narrowing gaps in clinical practice relative to guidelines is limited.
Methods And Results: Monte Carlo simulation was applied to 1.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!