Cardiovascular outcomes between dapagliflozin versus empagliflozin in patients with diabetes mellitus

Author:

Kim Jee‐Heon1ORCID,Yoon Young‐Chae1ORCID,Kim Young‐Hoon1ORCID,Park Jong‐Il12ORCID,Choi Kang‐Un12ORCID,Nam Jong‐Ho12ORCID,Lee Chan‐Hee12ORCID,Son Jang‐Won12ORCID,Park Jong‐Seon12ORCID,Kim Ung12ORCID

Affiliation:

1. Yeungnam University College of Medicine Daegu Republic of Korea

2. Division of Cardiology Yeungnam University Medical Center Daegu Republic of Korea

Abstract

AbstractBackgroundSodium‐glucose co‐transporter 2 (SGLT2) inhibitors have been demonstrated to decrease cardiovascular adverse events. However, there is little real‐world clinical evidence regarding a direct comparison between dapagliflozin and empagliflozin in patients with diabetes mellitus (DM).HypothesisA difference in the cardiovascular efficancy of dapagliflozin versus empagliflozin in DM patients was anticipated, aiming to guide the optimal choice of SGLT2 inhibitors based on cardiovascular outcomes.MethodsFrom 2014 to 2020, a total of 1549 patients with DM who were prescribed SGLT2 inhibitors such as dapagliflozin or empagliflozin were retrospectively enrolled. We categorized the study population into two groups: dapagliflozin (n = 981) and empagliflozin group (n = 568). The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of all‐cause death, myocardial infarction (MI), stroke, or hospitalization for heart failure (HF) over a 3‐year period.ResultsPropensity‐score matching was performed (537 patients in each group). The mean age and hemoglobin A1c were 58.2 ± 13.0 years and 8.4 ± 1.7%, respectively. There was no significant difference between the dapagliflozin and empagliflozin groups in the risk of MACE (3.7% vs. 4.8%, hazard ratio [HR], 1.31; 95% confidence interval [CI], 0.73–2.35; p = 0.349). Furthermore, there were no differences between the two groups in secondary endpoints including all‐cause death, MI, stroke, and hospitalization for HF. Prior MI and history of HF were independent predictors of MACE.ConclusionsDapagliflozin and empagliflozin showed no significant difference of real‐world clinical cardiovascular outcomes in patients with DM over a 3‐year period. Further large randomized clinical trials will be warranted for better evaluation.

Publisher

Wiley

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