{"id":"13772fcd7077","type":"article","url":"https://hartvaat.nl/2018/06/12/sglt2-remmers-en-cardiovasculaire-events-de-cvd-real-2-real-world-studie/","title":"SGLT2-remmers en cardiovasculaire events: de CVD-REAL 2 real-world studie","title_en":"Cardiovascular Events Associated With SGLT-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL 2 Study.","category":"preventie","category_label":"Preventie","professions":["apotheker","cardioloog","huisarts","internist"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2018.03.009","source_url":"https://doi.org/10.1016/j.jacc.2018.03.009","authors":["Mikhail Kosiborod","Carolyn S P Lam","Shun Kohsaka","Dae Jung Kim","Avraham Karasik","Jonathan Shaw","Navdeep Tangri","Su-Yen Goh","Marcus Thuresson","Hungta Chen","Filip Surmont","Niklas Hammar","Peter Fenici"],"significance":7,"published":"2018-06-12","source_date":"2018-06-12","image":"","kennis":["https://hartvaat.nl/kennis/preventie/preventie-bij-diabetes/","https://hartvaat.nl/kennis/cardiometabool/diabetes-type-1-en-hart/"],"congress":"","summary_en":"The CVD-REAL 2 study provided real-world evidence from 6 countries confirming that SGLT2 inhibitor use is associated with lower cardiovascular events and mortality compared with other glucose-lowering drugs in type 2 diabetes, extending the trial evidence to routine clinical practice.","created":"2026-07-03T10:27:20Z","updated":"2026-07-03T13:26:35Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"CVD-REAL 2 studie die real-world data uit 6 landen verzamelde over SGLT2-remmers en cardiovasculaire events bij diabetes. Bevestigt de EMPA-REG en CANVAS bevindingen in de praktijk.","abstract_original":"BACKGROUND: Randomized trials demonstrated a lower risk of cardiovascular (CV) events with sodium-glucose cotransporter-2 inhibitors (SGLT-2i) in patients with type 2 diabetes (T2D) at high CV risk. Prior real-world data suggested similar SGLT-2i effects in T2D patients with a broader risk profile, but these studies focused on heart failure and death and were limited to the United States and Europe. OBJECTIVES: The purpose of this study was to examine a broad range of CV outcomes in patients initiated on SGLT-2i versus other glucose-lowering drugs (oGLDs) across 6 countries in the Asia Pacific, the Middle East, and North American regions. METHODS: New users of SGLT-2i and oGLDs were identified via claims, medical records, and national registries in South Korea, Japan, Singapore, Israel, Australia, and Canada. Propensity scores for SGLT-2i initiation were developed in each country, with 1:1 matching. Hazard ratios (HRs) for death, hospitalization for heart failure (HHF), death or HHF, MI, and stroke were assessed by country and pooled using weighted meta-analysis. RESULTS: After propensity-matching, there were 235,064 episodes of treatment initiation in each group; ∼27% had established CV disease. Patient characteristics were well-balanced between groups. Dapagliflozin, empagliflozin, ipragliflozin, canagliflozin, tofogliflozin, and luseogliflozin accounted for 75%, 9%, 8%, 4%, 3%, and 1% of exposure time in the SGLT-2i group, respectively. Use of SGLT-2i versus oGLDs was associated with a lower risk of death (HR: 0.51; 95% confidence interval [CI]: 0.37 to 0.70; p < 0.001), HHF (HR: 0.64; 95% CI: 0.50 to 0.82; p = 0.001), death or HHF (HR: 0.60; 95% CI: 0.47 to 0.76; p < 0.001), MI (HR: 0.81; 95% CI: 0.74 to 0.88; p < 0.001), and stroke (HR: 0.68; 95% CI: 0.55 to 0.84; p < 0.001). Results were directionally consistent across both countries and patient subgroups, including those with and without CV disease. CONCLUSIONS: In this large, international study of patients with T2D from the Asia Pacific, the Middle East, and North America, initiation of SGLT-2i was associated with a lower risk of CV events across a broad range of outcomes and patient characteristics. (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors [CVD-REAL]; NCT02993614)."}