medwireNews: Dapagliflozin reduces the risk for adverse renal outcomes, and also adverse cardiovascular (CV) outcomes and mortality, shows a prespecified subgroup analysis of DAPA-CKD.
All of the 4304 trial participants had established renal disease, around two-thirds had type 2 diabetes, and 37.4% also had established CV disease (CVD) at baseline.
“While the cardiovascular risk of participants differed markedly in relation to baseline cardiovascular disease status, renal risk did not,” John McMurray (University of Glasgow, UK) and co-researchers note in Circulation.
Nevertheless, during the median follow-up of 2.4 years, dapagliflozin significantly reduced the risk for both renal and CVD endpoints, relative to placebo, regardless of participants’ baseline CVD status.
Specifically, dapagliflozin reduced the risk for the composite renal endpoint by an identical 39% in participants with and without pre-existing CVD. And it reduced the risk for CV death or heart failure hospitalization by 30% and 33% in these two groups, respectively.
The effect on the latter endpoint was driven by a reduction in heart failure hospitalization, and dapagliflozin had no significant effect on the risk for CV death, myocardial infarction, or stroke, even in the high-risk secondary prevention subgroup, in line with class effects on renal and heart failure, rather than atherosclerotic, outcomes.
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