Publications
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Decline in Estimated Glomerular Filtration Rate After Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Prespecified Secondary Analysis of the DELIVER Randomized Clinical Trial
JAMA Cardiol. 2023; online ahead of print DOI: 10.1001/jamacardio.2023.4664
An initial decline in eGFR often occurs after initiating a SGLT2i and has been observed in patients with diabetes, CKD and HF. A prespecified analysis of DELIVER evaluated the magnitude and frequency of an initial decline in eGFR (within the first month) and its association with CV and renal outcomes in 5,788 patients with HFpEF or HFmrEF.
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Efficacy of Finerenone in Patients with Type 2 Diabetes, Chronic Kidney Disease and Altered Markers of Liver Steatosis and Fibrosis: A FIDELITY Subgroup Analysis
Diabetes Obes Metab. 2023; online ahead of print DOI: 10.1111/dom.15305
This post hoc subgroup analysis from FIDELITY investigated the effect of finerenone on liver function, cardiovascular and kidney composite outcomes in patients with CKD and T2D, stratified by their risk of liver steatosis, inflammation and fibrosis.
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The Effects of Sodium-Glucose Cotransporter 2-Inhibitors on Steatosis and Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease or Steatohepatitis and Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials
Medicina (Kaunas). 2023;59:1136 DOI: 10.3390/medicina59061136
T2D and NAFLD/NASH share common causal pathways. As a class of glucose-lowering agents with well-established cardiovascular benefits, SGLT2i have been studied for effects on steatosis and fibrosis in patients with NAFLD or NASH. A systematic review was conducted to examine the efficacy of SGLT2i on NAFLD/NASH in patients who also had T2D.
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The Impact of Obesity on Cardiovascular and Kidney Outcomes in Patients with Chronic Kidney Disease and Type 2 Diabetes Treated with Finerenone: Post hoc analysis of the FIDELITY Study
Diabetes Obes Metab. 2023 doi Epub ahead of print : 10.1111/dom.15197
Patients with obesity may benefit more from treatment with mineralocorticoid receptor antagonists given their higher levels of circulating aldosterone and therefore potentially higher levels of MRs in visceral fat. The aim of this analysis was to assess the effect of finerenone on the risk of cardiovascular and kidney outcomes in patients with chronic kidney disease and type 2 diabetes, with and without obesity.
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Cardiac and Kidney Benefits of Empagliflozin in Heart Failure Across the Spectrum of Kidney Function: Insights From the EMPEROR-Preserved Trial
European Journal of Heart Failure 2023 DOI 10.1002/ejhf.2857
In the EMPEROR-Preserved trial, empagliflozin was found to improve the clinical outcomes of patients with heart failure and preserved ejection fraction (HFpEF). This pre-specified analysis sought to explore the effect of empagliflozin on cardiovascular (CV) and kidney outcomes across different levels of kidney function.
Benefits and Harms of Drug Treatment for Type 2 Diabetes: Systematic Review and Network Meta-Analysis of Randomised Controlled Trials
BMJ 2023;381:e074068 DOI 10.1136/bmj-2022-074068
Keeping abreast of the rising volume of randomized trials in adults with type 2 diabetes presents a formidable task. Recent randomized trials have shown cardiovascular and kidney advantages with finerenone, an innovative non-steroidal mineralocorticoid receptor antagonist, and weight loss with tirzepatide, a dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GLP-1) receptor agonist.
Empagliflozin Cardiovascular and Renal Effectiveness and Safety Compared to Dipeptidyl Peptidase-4 Inhibitors across 11 Countries in Europe and Asia: Results from the EMPagliflozin compaRative effectIveness and SafEty (EMPRISE) Study
Diabetes Metab. 2023; online ahead of print
Previously, the real-world EMPRISE US study found that empagliflozin initiation was associated with a lower risk of hospitalisation for HF, all-cause mortality and CV events when compared with DPP-4i.
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GLP-1 Receptor Agonists and Risk of Adverse Cerebrovascular Outcomes in Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
J Clin Endocrinol Metab. 2023; online ahead of print DOI: 10.1016/j.jacc.2022.07.021 10.1210/clinem/dgad076
Although the beneficial effects of GLP-1RAs on major cardiovascular events have been established in patients with T2D, their effects on cerebrovascular outcomes remain undetermined.
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Including Measures of Chronic Kidney Disease to Improve Cardiovascular Risk Prediction by SCORE2 and SCORE2-OP
Eur J Prev Cardiol. 2023;30:8–16 DOI: 10.1093/eurjpc/zwac176
The 2021 ESC guideline on CVD prevention categorises moderate and severe CKD as high and very-high CVD risk status regardless of other factors like age and does not include eGFR and albuminuria in its SCORE2 and SCORE2-OP algorithms to predict CVD risk. Here, three CKD ‘Add-ons' to SCORE2 and SCORE2-OP were developed and validated: eGFR only, eGFR + urinary albumin-to-creatinine ratio (the primary Add-on), and eGFR + dipstick proteinuria.
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Effects of Empagliflozin on Cardiovascular and Renal Outcomes in Heart Failure with Reduced Ejection Fraction According to Age: a Secondary Analysis of EMPEROR-Reduced
Eur J Heart Fail. 2022; online ahead of print DOI: 10.1002/ejhf.2707
Results from EMPEROR-Reduced demonstrated that empagliflozin improved CV and renal outcomes in patients with HFrEF, but its efficacy and safety across patient's age is not well established.