J Korean Diabetes > Volume 19(3); 2018 > Article
The Journal of Korean Diabetes 2018;19(3):135-139.
DOI: https://doi.org/10.4093/jkd.2018.19.3.135    Published online October 5, 2018.
관찰연구에서 확인된 SGLT2 억제제의 심혈관질환 예방효과: 한국인의 결과를 중심으로
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Preventive Effect of an SGLT2 Inhibitor on Cardiovascular Disease in an Observational Study: Results from a Korean Population.
Kyoung Hwa Ha, Dae Jung Kim
1Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea. djkim@ajou.ac.kr
2Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea.
3Institute on Aging, Ajou University Medical Center, Suwon, Korea.
Abstract
The sodium-glucose cotransporter-2 inhibitor (SGLT2i) is a new anti-hyperglycemic agent that have function to concomitantly inhibit the reabsorption of glucose and sodium in the renal proximal convoluting tubule. Recent two cardiovascular outcome trials showed that a lower risk of cardiovascular events with SGLT2i in people with type 2 diabetes. In addition, prior real-world data demonstrated similar SGLT2i effects, but these studies were limited to the United States and Europe. Thus, the CVD-REAL (Comparative Effectiveness of Cardiovascular Outcomes in New Users of Sodium-Glucose Cotransporter-2 Inhibitors) 2 Study was investigated cardiovascular outcomes in those initiated on SGLT2i versus other glucose-lowering drugs (oGLDs) across 6 countries in the Asia Pacific, the Middle East, and North American regions. In Korea, 336,644 episodes of initiation in SGLT2i or oGLD group between September 2014 and December 2016 were identified in Korea National Health Insurance database after propensity score matching. SGLT2i users was associated with a lower risk of all-cause death (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.67~0.77), hospitalization for heart failure (HHF) (HR, 0.87; 95% CI, 0.82~0.92), all-cause death or HHF (HR, 0.81; 95% CI, 0.78~0.85), myocardial infarction (HR, 0.81; 95% CI, 0.74~0.89), and stroke (HR, 0.82; 95% CI, 0.78~0.86) compared with oGLD users. In conclusion, initiation of SGLT2i had a lower risk of cardiovascular events in people with type 2 diabetes compared with oGLDs.
Key Words: Cardiovascular diseases, Observational study, Sodium-glucose cotransporter-2, Type 2 diabetes mellitus


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