Evidence map›Paper›PMID 35964039›Full record

ArticleCardiovascular diabetology2022

Contemporary use of SGLT2 inhibitors in heart failure patients with diabetes mellitus: a comparison of DPP4 inhibitors in a nationwide electric health database of the superaged society.

Michikazu Nakai, Yoshitaka Iwanaga, Koshiro Kanaoka, Yoko Sumita, Yuichi Nishioka, Tomoya Myojin, Shinichiro Kubo, Katsuki Okada, Tsunenari Soeda, Tatsuya Noda and 5 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.7field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Individualized treatment of diabetes mellitus in older adults.Geriatrics & gerontology international · 2024
    Review
  5. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 1 country.

Michikazu NakaiDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, Suita, Japan.
Yoshitaka IwanagaDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, Suita, Japan. yiwanaga@ncvc.go.jp.
Koshiro KanaokaDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, Suita, Japan.
Yoko SumitaDepartment of Medical and Health Information Management, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, Suita, Japan.
Yuichi NishiokaDepartment of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Japan.
Tomoya MyojinDepartment of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Japan.
Shinichiro KuboDepartment of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Japan.
Katsuki OkadaDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Tsunenari SoedaDepartment of Cardiovascular Medicine, Nara Medical University, Kashihara, Japan.
Tatsuya NodaDepartment of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Japan.
Yasushi SakataDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Tomoaki ImamuraDepartment of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Japan.
Yoshihiko SaitoDepartment of Cardiovascular Medicine, Nara Medical University, Kashihara, Japan.
Satoshi YasudaDepartment of Cardiovascular Medicine, Tohoku University Hospital, Tohoku University Graduate School of Medicine, Sendai, Japan.
Yoshihiro MiyamotoOpen Innovation Center, National Cerebral and Cardiovascular Center, Suita, Japan.
Nara Medical University · JPNational Cerebral and Cardiovascular Center · JPOsaka University · JPTohoku University Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is a lack of recent data reflecting the actual use of sodium-glucose cotransporter-2 (SGLT2) inhibitors for heart failure (HF) and type 2 diabetes (DM) in the superaged society. The present study investigated the association between the use of SGLT2 inhibitors and one-year prognosis in patients hospitalized across a broad spectrum of HF patients with DM in the superaged society using the Nationwide Electric Health Database in Japan.

methodsThe patients hospitalized with the first episode of acute HF were identified from the National Database of Health Insurance Claims and Specific Health Checkups of Japan between April 2014 and March 2019. A cohort of 2,277 users of SGLT2 inhibitors and 41,410 users of the active comparator, dipeptidyl peptidase-4 (DPP4) inhibitors were compared. A propensity score-matched cohort study of 2,101 users of each inhibitor was also conducted. A multivariable multilevel mixed-effects survival model was conducted with adjustments, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.

resultsAmong 300,398 patients discharged with HF in 4,176 hospitals, 216,016 (71.9%) were 75 years or older, and 60,999 (20.3%) took antidiabetic medications. Among them, the patients treated with SGLT2 inhibitors were younger and had a more severe status than those treated with DPP4 inhibitors. Kaplan-Meier analysis showed that patients treated with SGLT2 inhibitors had a lower mortality risk and HF readmission. In propensity-matched cohorts, SGLT2 inhibitor use was associated with a lower risk of mortality and HF readmission than DPP-4 inhibitor use (HR [95% CI]; 0.70 [0.56, 0.89] and 0.52 [0.45, 0.61], respectively). Very elderly (≥ 75 years) patients showed similar results. Favorable effects were also observed across all age groups, including ≥ 75 years, in patients with coronary artery disease or atrial fibrillation and with concomitant β-blocker, diuretics, or insulin.

conclusionThe use of SGLT2 inhibitors at discharge was associated with a lower risk of one-year mortality and HF readmission in patients across a broad spectrum of HF with DM in the superaged society. The findings further support the benefits of using SGLT2 inhibitors in very elderly HF care and complement the current evidence.

Indexed as

Diabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsHeart FailureSodium-Glucose Transporter 2 InhibitorsAgedCohort StudiesDipeptidyl Peptidase 4HumansHypoglycemic AgentsDipeptidyl Peptidase 4Dipeptidyl-Peptidase IV InhibitorsDPP4 protein, humanHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsAn SGLT2 inhibitorDiabetes mellitusNationwide Electric Health DatabaseOne-year prognosisSuperaged society

Identifiers

PMID35964039
PMCPMC9375946
OpenAlexW4291214617

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.