Obesity and Effects of Dapagliflozin on Cardiovascular and Renal Outcomes in Patients With Type 2 Diabetes Mellitus in the DECLARE-TIMI 58 trial

Eur Heart J 2022;43:2958-67

Obesity has a crucial role in the development and progression of type diabetes, which in turn is strongly and independently related to the risk of cardiorenal diseases. At present, there is little information about the association between obesity and cardiovascular outcomes and drug effect in people treated with sodium-glucose cotransporter-2 inhibitors (SGLT2i). This prespecified analysis of DECLARE-TIMI 58 used body mass index (BMI) to stratify 17,134 patients across weight categories, and then analysed clinical outcomes.

The authors conclude that – whereas relative risk reductions in cardiovascular 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 type 2 diabetes.