Incident heart failure and myocardial infarction in sodium‐glucose cotransporter‐2 vs. dipeptidyl peptidase‐4 inhibitor users

• Published in: ESC Heart Failure 2022-04, Vol.9 (2), p.1388-1399
• Main Authors: Zhou, Jiandong, Lee, Sharen, Leung, Keith Sai Kit, Wai, Abraham Ka Chung, Liu, Tong, Liu, Ying, Chang, Dong, Wong, Wing Tak, Wong, Ian Chi Kei, Cheung, Bernard Man Yung, Zhang, Qingpeng, Tse, Gary
• Format: Article
• Language: English
• Subjects: Aged; Beta blockers; Biomarkers; Cardiac arrhythmia; Demographics; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Dipeptidyl-Peptidase IV Inhibitors - adverse effects; Dipeptidyl-Peptidases and Tripeptidyl-Peptidases - therapeutic use; Disease; Drug use; Female; Glucose; Heart attacks; Heart failure; Heart Failure - drug therapy; High density lipoprotein; Humans; Ischemia; Laboratories; Lipoproteins; Lymphocytes; Male; Metabolism; Middle Aged; Mortality; Myocardial infarction; Myocardial Infarction - epidemiology; Neutrophils; Original; Patients; Population-based studies; Retrospective Studies; Sodium; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Sodium‐glucose co‐transporter; Standard deviation; Statistical analysis
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.13830

Aims This study aimed to compare the rates of major cardiovascular adverse events in sodium‐glucose cotransporter‐2 inhibitors (SGLT2I) and dipeptidyl peptidase‐4 inhibitors (DPP4I) users in a Chinese population. SGLT2I and DPP4I are increasingly prescribed for type 2 diabetes mellitus patients. However, few population‐based studies are comparing their effects on incident heart failure or myocardial infarction. Methods and results This was a population‐based retrospective cohort study using the electronic health record database in Hong Kong, including type 2 diabetes mellitus patients receiving either SGLT2I or DPP4I from 1 January 2015 to 31 December 2020. Propensity score matching was performed in a 1:1 ratio based on demographics, past comorbidities, and non‐SGLT2I/DPP4I medications with nearest neighbour matching (caliper = 0.1). Univariable and multivariable Cox models were used to identify significant predictors for new‐onset heart failure, new‐onset myocardial infarction, cardiovascular mortality, and all‐cause mortality. Sensitivity analyses with competing risk models and multiple propensity score matching approaches were conducted. A total of 41 994 patients (58.89% males, median admission age at 58 years old, interquartile range [IQR]: 51.2–65.3) were included with a median follow‐up of 5.6 years (IQR: 5.32–5.82). In the matched cohort, SGLT2I use was significantly associated with lower risks of new‐onset heart failure (hazard ratio [HR]: 0.73, 95% confidence interval [CI]: [0.66, 0.81], P