J Korean Diabetes.  2018 Sep;19(3):135-139. 10.4093/jkd.2018.19.3.135.

Preventive Effect of an SGLT2 Inhibitor on Cardiovascular Disease in an Observational Study: Results from a Korean Population

• Ha KH
• Kim DJ

• KMID: 2421293
• DOI: http://doi.org/10.4093/jkd.2018.19.3.135

Abstract

The sodium-glucose cotransporter-2 inhibitor (SGLT2i) is a new anti-hyperglycemic agent that have function to concomitantly inhibit the reabsorption of glucose and sodium in the renal proximal convoluting tubule. Recent two cardiovascular outcome trials showed that a lower risk of cardiovascular events with SGLT2i in people with type 2 diabetes. In addition, prior real-world data demonstrated similar SGLT2i effects, but these studies were limited to the United States and Europe. Thus, the CVD-REAL (Comparative Effectiveness of Cardiovascular Outcomes in New Users of Sodium-Glucose Cotransporter-2 Inhibitors) 2 Study was investigated cardiovascular outcomes in those initiated on SGLT2i versus other glucose-lowering drugs (oGLDs) across 6 countries in the Asia Pacific, the Middle East, and North American regions. In Korea, 336,644 episodes of initiation in SGLT2i or oGLD group between September 2014 and December 2016 were identified in Korea National Health Insurance database after propensity score matching. SGLT2i users was associated with a lower risk of all-cause death (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.67~0.77), hospitalization for heart failure (HHF) (HR, 0.87; 95% CI, 0.82~0.92), all-cause death or HHF (HR, 0.81; 95% CI, 0.78~0.85), myocardial infarction (HR, 0.81; 95% CI, 0.74~0.89), and stroke (HR, 0.82; 95% CI, 0.78~0.86) compared with oGLD users. In conclusion, initiation of SGLT2i had a lower risk of cardiovascular events in people with type 2 diabetes compared with oGLDs.

Keyword

Cardiovascular diseases; Observational study; Sodium-glucose cotransporter-2; Type 2 diabetes mellitus

MeSH Terms

Asia
Cardiovascular Diseases*
Diabetes Mellitus, Type 2
Europe
Glucose
Heart Failure
Hospitalization
Korea
Middle East
Myocardial Infarction
National Health Programs
Observational Study*
Propensity Score
Sodium
Stroke
United States
Glucose
Sodium

Figure

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  Fig. 1 Cardiovascular outcomes associated with sodium-glucose cotransporter-2 inhibitor (SGLT2i) and other glucose-lowering drug (oGLD) in Korea. Modified from the article of Kosiborod et al. (J Am Coll Cardiol 2018;71:2628-39) [7] with original copyright holder's permission. HHF, hospitalization for heart failure; PY, person-year; CI, confidence interval.

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