Evidence map›Paper›PMID 31382965›Full record

ReviewCardiovascular diabetology2019

Class effects of SGLT2 inhibitors on cardiorenal outcomes.

Aaron Y Kluger, Kristen M Tecson, Andy Y Lee, Edgar V Lerma, Janani Rangaswami, Norman E Lepor, Michael E Cobble, Peter A McCullough

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PubMed Full text at PMC Publisher
In one paragraph

Review in Cardiovascular diabetology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 8 pooled it
–field-weighted citation impact
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

76 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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16 more citing papers are in PubMed but not listed here.

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

8 authors.

Aaron Y KlugerBaylor Heart and Vascular Institute, 621 N. Hall #H030, Dallas, TX, 75226, USA. Aaron.Kluger@BSWHealth.org.ORCID 0000-0003-2967-0238
Kristen M TecsonBaylor Heart and Vascular Institute, 621 N. Hall #H030, Dallas, TX, 75226, USA.
Andy Y LeeBaylor University Medical Center, Dallas, TX, USA.
Edgar V LermaUIC/Advocate Christ Medical Center, Oak Lawn, IL, USA.
Janani RangaswamiEinstein Medical Center, Philadelphia, PA, USA.
Norman E LeporDavid Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Michael E CobbleUniversity of Utah School of Medicine, Salt Lake City, UT, USA.
Peter A McCulloughBaylor Heart and Vascular Institute, 621 N. Hall #H030, Dallas, TX, 75226, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo summarize the four recent sodium-glucose cotransporter 2 inhibitor (SGLT2i) trials: Dapagliflozin Effect on CardiovascuLAR Events (DECLARE-TIMI 58), CANagliflozin CardioVascular Assessment Study (CANVAS) Program, Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients-Removing Excess Glucose (EMPA-REG OUTCOME), Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE), and explore the potential determinants for their cardiovascular, renal, and safety outcomes.

resultsThe composite renal outcome event rates per 1000 patient-years for drug and placebo, as well as the corresponding relative risk reductions, were 3.7, 7.0, 47%; 5.5, 9.0, 40%; 6.3, 11.5, 46%; 43.2, 61.2, 30% for DECLARE-TIMI 58, CANVAS, EMPA-REG OUTCOME, and CREDENCE, respectively (event definitions varied across trials). The major adverse cardiovascular (CV) event rates per 1000 patient-years for drug and placebo, as well as the corresponding relative risk reductions, were 22.6, 24.2, 7%; 26.9, 31.5, 14%; 37.4, 43.9, 14%; 38.7, 48.7, 20% for DECLARE-TIMI 58, CANVAS, EMPA-REG OUTCOME, and CREDENCE, respectively. DECLARE-TIMI 58 had the fewest cardiorenal events and CREDENCE the most. These differences were presumably due to varying inclusion criteria resulting in DECLARE-TIMI 58 having the best baseline renal filtration function and CREDENCE the worst (mean estimated glomerular filtration rate 85.2, 76.5, 74, 56.2 mL/min/1.73 m

conclusionsDapagliflozin, empagliflozin, and canagliflozin have internally and externally consistent and biologically plausible class effects on cardiorenal outcomes. Baseline renal filtration function and degree of albuminuria are the most significant indicators of risk for both CV and renal events. Thus, these two factors also anticipate the greatest clinical benefit for SGLT2i.

Indexed as

Benzhydryl CompoundsCanagliflozinCardiovascular DiseasesCardiovascular SystemDiabetes Mellitus, Type 2Diabetic NephropathiesDisease ProgressionGlucosidesHumansKidneyProtective FactorsRandomized Controlled Trials as TopicRenal Insufficiency, ChronicRisk AssessmentRisk FactorsSodium-Glucose Transporter 2 InhibitorsBenzhydryl CompoundsCanagliflozindapagliflozinempagliflozinGlucosidesSodium-Glucose Transporter 2 InhibitorsAlbuminuriaCanagliflozinCANVASCardiovascular deathCardiovascular outcome trialsChronic kidney diseaseCREDENCEDapagliflozinDECLARE-TIMI 58EmpagliflozinEMPA–REG OUTCOMEEnd-stage renal diseaseEstimated glomerular filtration functionHeart failure hospitalizationMortalitySGLT2 inhibitor

Identifiers

PMID31382965
PMCPMC6683461

What Socratic holds

Textfull text, public
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.