Stanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
The George Institute for Global Health, UNSW Sydney, New South Wales, Australia.
Am Heart J. 2021 Mar;233:141-148. doi: 10.1016/j.ahj.2020.12.008. Epub 2020 Dec 22.
We aimed to assess the efficacy and safety of canagliflozin in patients with type 2 diabetes and nephropathy according to prior history of heart failure in the Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation (CREDENCE) trial. We found that participants with a prior history of heart failure at baseline (15%) were more likely to be older, female, white, have a history of atherosclerotic cardiovascular disease, and use diuretics and beta blockers (all P < .001), and that, compared with placebo, canagliflozin safely reduced renal and cardiovascular events with consistent effects in patients with and without a prior history of heart failure (all efficacy P interaction >.150). These results support the efficacy and safety of canagliflozin in patients with type 2 diabetes and nephropathy regardless of prior history of heart failure.
我们旨在根据心力衰竭既往史评估卡格列净在 CREDENCE 试验中患有 2 型糖尿病和肾病患者中的疗效和安全性。我们发现,基线时存在心力衰竭既往史的参与者更可能年龄较大、女性、白人、有动脉粥样硬化性心血管疾病史,并且使用利尿剂和β受体阻滞剂(均 P<.001),与安慰剂相比,卡格列净可安全降低肾脏和心血管事件,且在有和无心力衰竭既往史的患者中具有一致的疗效(所有疗效 P 交互作用>.150)。这些结果支持卡格列净在患有 2 型糖尿病和肾病的患者中的疗效和安全性,无论其心力衰竭既往史如何。