Reduction in cardiovascular disease events in patients with type 2 diabetes mellitus treated with a sodium–glucose cotransporter 2 inhibitor versus a dipeptidyl peptidase‐4 inhibitor: A real‐world retrospective administrative database analysis in Japan

Figure 1. Patient disposition. CVD, cardiovascular disease; DPP4i, dipeptidyl peptidase‐4 inhibitor; hHF, hospitalization for heart failure; MDV, Medical Data Vision; SGLT2i, sodium–glucose cotransporter 2 inhibitor; T2DM, type 2 diabetes mellitus.

Figure 2. Forest plot of the risk of hospitalization for heart failure (hHF), all‐cause death (ACD), a composite of hHF or ACD, hospitalization for myocardial infarction (MI) and hospitalization for stroke, in the full cohort and in patients with and without a cardiovascular disease (CVD) history. CI, confidence interval; DPP4i, dipeptidyl peptidase‐4 inhibitor; HR, hazard ratio; SGLT2i, sodium–glucose cotransporter 2 inhibitor.

Figure 3. Kaplan–Meier curve of cumulative rate of hospitalization for heart failure (hHF) in (a) the full cohort, (b) patients with a cardiovascular disease (CVD) history and (c) patients without a CVD history. The weighted cumulative hHF rate in sodium–glucose cotransporter 2 inhibitor (SGLT2i)‐treated patients was higher than that in dipeptidyl peptidase‐4 inhibitor (DPP4i)‐treated patients 30–60 days after the index date, in the full cohort and in patients with a CVD history; the cumulative hHF rate tended to be lower in SGLT2i‐treated patients than in DPP4i‐treated patients after 1 year from the index date. In contrast, among patients without a CVD history, the cumulative hHF rate in SGLT2i‐treated patients was lower at almost all time points from 90 days after the index date than in DPP4i‐treated patients.

Figure 4. Kaplan–Meier curve of cumulative rate of all‐cause death (ACD) in (a) the full cohort, (b) patients with a cardiovascular disease (CVD) history, and (c) patients without a CVD history. The weighted cumulative rate of ACD was lower in sodium–glucose cotransporter 2 (SGLT2i)‐treated patients compared with dipeptidyl peptidase‐4 inhibitor (DPP4i)‐treated patients at all time points after initiation of the respective drugs in the full cohort and both CVD subcohorts.

Figure 5. Kaplan–Meier curve of cumulative rate of the composite of hospitalization for heart failure (hHF) or all‐cause death (ACD) in (a) the full cohort, (b) patients with a cardiovascular disease (CVD) history and (c) patients without a CVD history. The weighted cumulative rate of the composite of hHF or ACD was lower in sodium–glucose cotransporter 2 inhibitor (SGLT2i)‐treated patients compared with dipeptidyl peptidase‐4 inhibitor (DPP4i)‐treated patients at almost all time points after initiation of the respective drugs in the full cohort and both CVD subcohorts.

Figure 6. Subgroup analysis (<75 years; ≥75 years). Forest plot of the risk of hospitalization for heart failure (hHF), all‐cause death (ACD), hHF or ACD, hospitalization for myocardial infarction (MI), and hospitalization for stroke in (a) the full cohort, (b) patients with a cardiovascular disease (CVD) history and (c) patients without a CVD history. CI, confidence interval; DPP4i, dipeptidyl peptidase‐4 inhibitor; HR, hazard ratio; SGLT2i, sodium–glucose cotransporter 2 inhibitor.