NDLI: Empagliflozin is associated with lower cardiovascular risk compared with dipeptidyl peptidase-4 inhibitors in adults with and without cardiovascular disease: EMPagliflozin compaRative effectIveness and SafEty (EMPRISE) study results from Europe and Asia

Content Provider	Springer Nature : BioMed Central
Author	Vistisen, Dorte Carstensen, Bendix Elisabetta, Patorno Lanzinger, Stefanie Tan, Elise Chia-Hui Yabe, Daisuke Kim, Dae Jung Sheu, Wayne H.-H. Melzer-Cohen, Cheli Holl, Reinhard W. Núñez, Júlio Ha, Kyoung Hwa Halvorsen, Sigrun Langslet, Gisle Karasik, Avraham Nyström, Thomas Niskanen, Leo Guleria, Sonia Klement, Riho Carrasco, Marc Foersch, Johannes Shay, Christina Koeneman, Lisette Hoti, Fabian Farsani, Soulmaz Fazeli Khunti, Kamlesh Zaccardi, Francesco Subramanian, Anuradhaa Nirantharakumar, Krishnarajah
Abstract	Background Studies that have reported lower risk for cardiovascular outcomes in users of Sodium–Glucose Cotransporter-2 Inhibitors (SGLT-2i) are limited by residual cofounding and lack of information on prior cardiovascular disease (CVD). This study compared risk of cardiovascular events in patients within routine care settings in Europe and Asia with type 2 diabetes (T2D) initiating empagliflozin compared to dipeptidyl peptidase-4 inhibitors (DPP-4i) stratified by pre-existing CVD and history of heart failure (HF). Methods and results Adults initiating empagliflozin and DPP-4i in 2014–2018/19 from 11 countries in Europe and Asia were compared using propensity score matching and Cox proportional hazards regression to assess differences in rates of primary outcomes: hospitalisation for heart failure (HHF), myocardial infarction (MI), stroke; and secondary outcomes: cardiovascular mortality (CVM), coronary revascularisation procedure, composite outcome including HHF or CVM, and 3-point major adverse cardiovascular events (MACE: MI, stroke and CVM). Country-specific results were meta-analysed and pooled hazard ratios (HR) with 95% confidence intervals (CI) from random-effects models are presented. In total, 85,244 empagliflozin/DPP4i PS-matched patient pairs were included with overall mean follow-up of 0.7 years. Among those with pre-existing CVD, lower risk was observed for HHF (HR 0.74; 95% CI 0.64–0.86), CVM (HR 0.55; 95% CI 0.38–0.80), HHF or CVM (HR 0.57; 95% CI 0.48–0.67) and stroke (HR 0.79; 95% CI 0.67–0.94) in patients initiating empagliflozin vs DPP-4i. Similar patterns were observed among patients without pre-existing CVD and those with and without pre-existing HF. Conclusion These results from diverse patient populations in routine care settings across Europe and Asia demonstrate that initiation of empagliflozin compared to DPP-4i results in favourable cardioprotective effects regardless of pre-existing CVD or HF status.
Related Links	https://cardiab.biomedcentral.com/counter/pdf/10.1186/s12933-023-01963-9.pdf
Ending Page	12
Page Count	12
Starting Page	1
File Format	HTM / HTML
ISSN	14752840
DOI	10.1186/s12933-023-01963-9
Journal	Cardiovascular Diabetology
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2023-08-31
Access Restriction	Open
Subject Keyword	Diabetes Angiology Cardiology Empagliflozin Dipeptidyl peptidase-4 inhibitors Type 2 diabetes Cardiovascular disease Heart failure Comparative effectiveness
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Internal Medicine Endocrinology, Diabetes and Metabolism
Journal Impact Factor	8.5/2023
5-Year Journal Impact Factor	8.9/2023

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Empagliflozin is associated with lower cardiovascular risk compared with dipeptidyl peptidase-4 inhibitors in adults with and without cardiovascular disease: EMPagliflozin compaRative effectIveness and SafEty (EMPRISE) study results from Europe and Asia