Evidence mapPaperPMID 34688282Full record

Observational studyCardiovascular diabetology2021

Differences in outcomes of hospitalizations for heart failure after SGLT2 inhibitor treatment: effect modification by atherosclerotic cardiovascular disease.

Shih-Chieh Shao, Kai-Cheng Chang, Swu-Jane Lin, Shang-Hung Chang, Ming-Jui Hung, Yuk-Ying Chan, Edward Chia-Cheng Lai

Open access · goldAbstract readComparative StudyMulticenter StudyObservational Study
In one paragraph

Observational study in Cardiovascular diabetology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
3.5field-weighted citation impact, top 6% 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

20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.

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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

7 authors at 6 institutions in 2 countries.

Shih-Chieh ShaoDepartment of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
Kai-Cheng ChangSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 701, Taiwan.
Swu-Jane LinDepartment of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.
Shang-Hung ChangSection of Cardiology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Ming-Jui HungChang Gung University, College of Medicine, Taoyuan, Taiwan.
Yuk-Ying ChanDepartment of Pharmaceutical Material Management, Chang Gung Medical Foundation, Taoyuan, Taiwan.
Edward Chia-Cheng LaiSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 701, Taiwan. edward_lai@mail.ncku.edu.tw.ORCID 0000-0002-5852-7652
Linkou Chang Gung Memorial Hospital · TWChang Gung Memorial Hospital · TWChang Gung University · TWKeelung Chang Gung Memorial Hospital · TWNational Cheng Kung University · TWUniversity of Illinois Chicago · US

Funding

chang gung medical foundation CMRPG3H1553ministry of science and technology of taiwan 107-2320-B-006-070-MY3
6 · The paper itself

Abstract

backgroundThe treatment effects on hospitalization for heart failure (hHF) from sodium-glucose cotransporter 2 (SGLT2) inhibitors may vary among type 2 diabetes (T2D) patients depending on whether or not they have established atherosclerotic cardiovascular diseases (ASCVD). We aimed to examine differences in hHF outcomes after dapagliflozin or empagliflozin use between T2D patients with and without a history of established ASCVD.

methodsWe conducted a retrospective multi-institutional cohort study in Taiwan. We included T2D patients newly receiving dapagliflozin or empagliflozin during 2016-2019, and followed them up until December 31, 2020. We implemented 1:1 propensity score matching to create homogenous groups for comparisons. We generated Cox proportional hazard models to compare the risk of hHF between dapagliflozin and empagliflozin (reference group). We included interaction terms of SGLT2 inhibitor and ASCVD history in the regression models to examine effect modification by ASCVD.

resultsWe included a total cohort of 9,586 dapagliflozin new users and 9,586 matched empagliflozin new users. The overall hHF risks were similar for dapagliflozin and empagliflozin (HR: 0.90, 95% CI 0.74-1.09). However, differential hHF risks between dapagliflozin and empagliflozin were observed only in the subgroup without ASCVD (HR: 0.67, 95% CI 0.49-0.90), while not in the subgroup with ASCVD (HR: 1.12, 95% 0.87-1.45), and the p-value for examining interaction was 0.0097.

conclusionIn this study, history of established ASCVD was associated with different hHF risks among SGLT2 inhibitors. For T2D patients without ASCVD, dapagliflozin may offer a more favorable hHF reduction effect, compared to empagliflozin, in clinical practice. Future prospective studies should be conducted to validate our findings.

Indexed as

HospitalizationAgedAtherosclerosisBenzhydryl CompoundsDiabetes Mellitus, Type 2FemaleGlucosidesHeart FailureHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsSodium-Glucose Transporter 2 InhibitorsTaiwanBenzhydryl CompoundsdapagliflozinempagliflozinGlucosidesSodium-Glucose Transporter 2 InhibitorsAnti-diabetic drugsAtherosclerotic cardiovascular diseasesEffect modificationHospitalization for heart failureSodium-glucose cotransporter 2 inhibitors

Identifiers

PMID34688282
PMCPMC8542324
OpenAlexW3210044928

What Socratic holds

Textmetadata
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.