Obesity and effects of dapagliflozin on cardiovascular and
renal outcomes in patients with type 2 diabetes mellitus in the
DECLARE–TIMI 58 trial

J 2022

Obesity and effects of dapagliflozin on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus in the DECLARE–TIMI 58 trial

OYAMA, Kazuma, Itamar RAZ, Avivit CAHN, Julia KUDER, Sabina MURPHY et. al.

Basic information

Original name

Obesity and effects of dapagliflozin on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus in the DECLARE–TIMI 58 trial

Authors

OYAMA, Kazuma, Itamar RAZ, Avivit CAHN, Julia KUDER, Sabina MURPHY, Deepak L. BHATT, Lawrence A. LEITER, Darren K. MCGUIRE, John P. H. WILDING, Kyong-Soo PARK, Assen GOUDEV, Rafael DIAZ, Jindřich ŠPINAR (203 Czech Republic, belonging to the institution), Ingrid A. M. GAUSE-NILSSON, Ofri MOSENZON, Marc S. SABATINE and Stephen D. WIVIOTT

Edition

European Heart Journal, OXFORD, OXFORD UNIV PRESS, 2022, 0195-668X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 39.300

RIV identification code

RIV/00216224:14110/22:00125194

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1093/eurheartj/ehab530

UT WoS

000756673900001

Keywords in English

Type 2 diabetes mellitus • Obesity • Cardiovascular death; Heart failure; Sodium-glucose co transporter 2 inhibitors

Abstract

V originále

Aims We investigated the associations between obesity, cardiorenal events, and benefits of dapagliflozin in patients with type 2 diabetes mellitus (T2DM). Methods and results DECLARE–TIMI 58 randomized patients with T2DM and either atherosclerotic cardiovascular (CV) disease or multiple risk factors to dapagliflozin vs. placebo. Patients were stratified by body mass index (BMI, kg/m2): normal (18.5 to <25), overweight (25 to <30), moderately obese (30 to <35), severely obese (35 to <40), and very-severely obese (≥40). Outcomes analysed were CV death, hospitalization for heart failure (HHF), renal-specific composite outcome, and atrial fibrillation or flutter (AF/AFL). Of 17 134 patients, 9.0% had a normal BMI, 31.5% were overweight, 32.4% were moderately, 17.2% severely, and 9.8% were very-severely obese. Higher BMI was associated with a higher adjusted risk of HHF and AF/AFL (hazard ratio 1.30 and 1.28, respectively, per 5 kg/m2; P < 0.001 for all). Dapagliflozin reduced body weight by similar relative amounts consistently across BMI categories (percent difference: −1.9 to −2.4%). Although relative risk reductions in CV and renal-specific composite outcomes with dapagliflozin did not significantly differ across the range of BMI (P for interaction ≥0.20 for all outcomes), obese patients (BMI ≥ 30 kg/m2) tended to derive greater absolute risk reduction in HHF and AF/AFL (P for interaction 0.02 and 0.09, respectively) than non-obese patients. Conclusions In DECLARE–TIMI 58, patients with T2DM and higher BMI were more likely to have HHF and AF/AFL. Whereas relative risk reductions in CV and renal outcomes with dapagliflozin were generally consistent across the range of BMI, absolute risk reduction in obesity-related outcomes including HHF and AF/AFL tended to be larger in obese patients with T2DM.

Citovat

OYAMA, Kazuma, Itamar RAZ, Avivit CAHN, Julia KUDER, Sabina MURPHY, Deepak L. BHATT, Lawrence A. LEITER, Darren K. MCGUIRE, John P. H. WILDING, Kyong-Soo PARK, Assen GOUDEV, Rafael DIAZ, Jindřich ŠPINAR, Ingrid A. M. GAUSE-NILSSON, Ofri MOSENZON, Marc S. SABATINE and Stephen D. WIVIOTT. Obesity and effects of dapagliflozin on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus in the DECLARE–TIMI 58 trial. European Heart Journal. OXFORD: OXFORD UNIV PRESS, 2022, vol. 43, No 31, p. 2958-2967. ISSN 0195-668X. Available from: https://dx.doi.org/10.1093/eurheartj/ehab530.

@article{1823832,
   author = {Oyama, Kazuma and Raz, Itamar and Cahn, Avivit and Kuder, Julia and Murphy, Sabina and Bhatt, Deepak L. and Leiter, Lawrence A. and McGuire, Darren K. and Wilding, John P. H. and Park, KyongandSoo and Goudev, Assen and Diaz, Rafael and Špinar, Jindřich and GauseandNilsson, Ingrid A. M. and Mosenzon, Ofri and Sabatine, Marc S. and Wiviott, Stephen D.},
   article_location = {OXFORD},
   article_number = {31},
   doi = {http://dx.doi.org/10.1093/eurheartj/ehab530},
   keywords = {Type 2 diabetes mellitus • Obesity • Cardiovascular death; Heart failure; Sodium-glucose co transporter 2 inhibitors},
   language = {eng},
   issn = {0195-668X},
   journal = {European Heart Journal},
   title = {Obesity and effects of dapagliflozin on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus in the DECLARE–TIMI 58 trial},
   url = {https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehab530/6356825?redirectedFrom=fulltext},
   volume = {43},
   year = {2022}
}

TY  - JOUR
ID  - 1823832
AU  - Oyama, Kazuma - Raz, Itamar - Cahn, Avivit - Kuder, Julia - Murphy, Sabina - Bhatt, Deepak L. - Leiter, Lawrence A. - McGuire, Darren K. - Wilding, John P. H. - Park, Kyong-Soo - Goudev, Assen - Diaz, Rafael - Špinar, Jindřich - Gause-Nilsson, Ingrid A. M. - Mosenzon, Ofri - Sabatine, Marc S. - Wiviott, Stephen D.
PY  - 2022
TI  - Obesity and effects of dapagliflozin on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus in the DECLARE–TIMI 58 trial
JF  - European Heart Journal
VL  - 43
IS  - 31
SP  - 2958-2967
EP  - 2958-2967
PB  - OXFORD UNIV PRESS
SN  - 0195668X
KW  - Type 2 diabetes mellitus • Obesity • Cardiovascular death
KW  - Heart failure
KW  - Sodium-glucose co transporter 2 inhibitors
UR  - https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehab530/6356825?redirectedFrom=fulltext
N2  - Aims We investigated the associations between obesity, cardiorenal events, and benefits of dapagliflozin in patients with type 2 diabetes mellitus (T2DM). Methods and results DECLARE–TIMI 58 randomized patients with T2DM and either atherosclerotic cardiovascular (CV) disease or multiple risk factors to dapagliflozin vs. placebo. Patients were stratified by body mass index (BMI, kg/m2): normal (18.5 to <25), overweight (25 to <30), moderately obese (30 to <35), severely obese (35 to <40), and very-severely obese (≥40). Outcomes analysed were CV death, hospitalization for heart failure (HHF), renal-specific composite outcome, and atrial fibrillation or flutter (AF/AFL). Of 17 134 patients, 9.0% had a normal BMI, 31.5% were overweight, 32.4% were moderately, 17.2% severely, and 9.8% were very-severely obese. Higher BMI was associated with a higher adjusted risk of HHF and AF/AFL (hazard ratio 1.30 and 1.28, respectively, per 5 kg/m2; P < 0.001 for all). Dapagliflozin reduced body weight by similar relative amounts consistently across BMI categories (percent difference: −1.9 to −2.4%). Although relative risk reductions in CV and renal-specific composite outcomes with dapagliflozin did not significantly differ across the range of BMI (P for interaction ≥0.20 for all outcomes), obese patients (BMI ≥ 30 kg/m2) tended to derive greater absolute risk reduction in HHF and AF/AFL (P for interaction 0.02 and 0.09, respectively) than non-obese patients. Conclusions In DECLARE–TIMI 58, patients with T2DM and higher BMI were more likely to have HHF and AF/AFL. Whereas relative risk reductions in CV and renal outcomes with dapagliflozin were generally consistent across the range of BMI, absolute risk reduction in obesity-related outcomes including HHF and AF/AFL tended to be larger in obese patients with T2DM.
ER  -

OYAMA, Kazuma, Itamar RAZ, Avivit CAHN, Julia KUDER, Sabina MURPHY, Deepak L. BHATT, Lawrence A. LEITER, Darren K. MCGUIRE, John P. H. WILDING, Kyong-Soo PARK, Assen GOUDEV, Rafael DIAZ, Jindřich ŠPINAR, Ingrid A. M. GAUSE-NILSSON, Ofri MOSENZON, Marc S. SABATINE and Stephen D. WIVIOTT. Obesity and effects of dapagliflozin on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus in the DECLARE–TIMI 58 trial. \textit{European Heart Journal}. OXFORD: OXFORD UNIV PRESS, 2022, vol.~43, No~31, p.~2958-2967. ISSN~0195-668X. Available from: https://dx.doi.org/10.1093/eurheartj/ehab530.

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