Abstract:
BACKGROUND:Sodium glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP1-RA) reduce cardiovascular events, and improve intermediate markers of cardiometabolic health, in those with type 2 diabetes. We investigated these effects in the CANVAS Program. METHODS AND RESULTS:The CANVAS Program comprised 2 double-blind, randomized, placebo-controlled trials (CANVAS and CANVAS-R) done in patients with type 2 diabetes and elevated cardiovascular risk. Effects were estimated using mixed-effects models for continuous measures and Cox regression models for other outcomes. Randomized treatment by subgroup interaction terms were used to compare effects of canagliflozin versus placebo across subgroups defined by baseline use of GLP1-RA. There were 10,142 participants, of whom 407 (4%) were using GLP1-RA therapy at baseline. Those using GLP1-RA at baseline were less likely to have a history of cardiovascular disease (60.4% vs 65.8%), had a longer duration of diabetes (15.2 vs 13.5 years) and a higher body mass index (BMI; 35.6 vs 31.8 kg/m2) but were otherwise similar. There were greater reductions with canagliflozin versus placebo for HbA1c (-0.75% versus -0.58%; P = .0091), SBP (-6.26 versus -3.83 mmHg; P = .0018), and body weight (-3.79 versus -2.18 kg; P < .0001) in those on baseline GLP1-RA therapy. Effects across subgroups were similar for UACR (P = .21), eGFR slope (P = .72), major adverse cardiac events (P = .94) and total serious adverse events (P = .74). CONCLUSIONS:There may be a synergistic effect of SGLT2 inhibition when used on a background of GLP1-RA for intermediate cardiometabolic markers.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Arnott C,Neuen BL,Heerspink HJL,Figtree GA,Kosiborod M,Lam CS,Cannon CP,Rosenthal N,Shaw W,Mahaffey KW,Jardine MJ,Perkovic V,Neal Bdoi
10.1016/j.ijcard.2020.06.011subject
Has Abstractpub_date
2020-11-01 00:00:00pages
126-129eissn
0167-5273issn
1874-1754pii
S0167-5273(20)33389-1journal_volume
318pub_type
杂志文章abstract:BACKGROUND:Endothelial cell recovery requires replenishment of primary cells from the endothelial lineage. However, recent evidence suggests that cells of the innate immune system enhance endothelial regeneration. METHODS AND RESULTS:Focusing on mature CD11b+-monocytes, we analyzed the fate and the effect of transfuse...
journal_title:International journal of cardiology
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journal_title:International journal of cardiology
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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