Introduction and Objective: Despite cardiovascular benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2i), treatment persistence is suboptimal in routine clinical practice. We investigated whether longer treatment durations offer greater cardiovascular benefits.Methods: We used nationwide healthcare data of South Korea (2012-2023) to emulate a target trial comparing following treatment strategies: treated with SGLT2i for <1 year, 1-2 years, 2-3 years, and ≥3 years among patients with type 2 diabetes. Primary outcomes were major adverse cardiovascular events (MACE) and hospitalization for heart failure (HHF). Cloning, censoring, and weighting methods were applied, and 5-year absolute risks, risk differences, and risk ratios were estimated using weighted Kaplan-Meier methods.Results: 1,174,088 eligible patients initiating SGLT2i were identified (mean age 57.3 years; 40.5% female). Compared to patients treated with SGLT2i for <1 year, those treated for 1-2 years, 2-3 years, and ≥3 years had progressively lower risks of MACE (RRs: 0.93 [95% CI, 0.90-0.96], 0.82 [0.78-0.85], and 0.69 [0.67-0.72], respectively) and HHF (RRs: 0.93 [0.90-0.97], 0.91 [0.80-0.99], and 0.74 [0.67-0.79], respectively) over a 5-year follow-up.Conclusion: Longer SGLT2i use was associated with progressively lower cardiovascular risk, highlighting cardioprotective benefits of sustained treatment.
B. Hong: None. K. Jung: None. H. Lee: None. J. Bae: None. Y. Cho: Other – Outside director; Current; Daewoong Pharmaceuticals, Korea. Advisory Panel; Ended; Hanmi Pharm. Co., Ltd. J. Kim: None. J. Shin: None.
Ministry of Food and Drug Safety (RS-2024-00393167), Ministry of Health & Welfare (RS-2025-02215225)
Source link
Leave a Reply