Why the study?
To evaluate the effect of SGLT2 inhibitors on cardiovascular outcomes in a real-world setting using electronic health records.
Do SGLT2 inhibitors reduce the risk of stroke or myocardial infarction compared to DPP-4 inhibitors in a real-world clinical setting?
Do SGLT2 inhibitors reduce the risk of stroke or myocardial infarction compared to DPP-4 inhibitors in a real-world clinical setting?
Real-world electronic health record data from the US confirms that SGLT2 inhibitors reduce the risk of stroke and myocardial infarction compared to DPP-4 inhibitors.
May support preferring SGLT2 inhibitors over DPP-4 inhibitors in real-world settings; leaves open need for randomized confirmation.
AIM: To evaluate the effect on cardiovascular outcomes of sodium-glucose co-transporter-2 (SGLT2) inhibitors in a real world setting by analyzing electronic medical records. METHODS: We used TriNetX, a global federated research network providing statistics on electronic health records (EHR). The analytics subset contained EHR from approximately 38 Million patients in 35 Health Care Organizations in the United States. The records of 46,909 patients who had taken SGLT2 inhibitors were compared to 189,120 patients with dipeptidyl peptidase (DPP) 4 inhibitors. We identified five potential confounding factors and built respective strata: elderly, hypertension, chronic kidney disease (CKD), and co-medication with either insulin or metformin. Cardiovascular events were counted as stroke (ICD10 code: I63) or myocardial infarction (ICD10: I21) occurring within three years after the first instance of the respective medication in the patients' records. RESULTS: control, with Risk Ratio ranging from 0.62 to 0.81. CONCLUSION: Real world data replicated the results from randomized clinical trials, confirmed the cardiovascular advantages of SGLT2 inhibitors, and showed its applicability to the US population.
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Manfred Stapff (2018) studied this question.
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