Effects of Sodium–Glucose Cotransporter 2 Inhibitors on Stage 4 Cardiovascular–Kidney–Metabolic Syndrome: A Propensity Score–Matched Study

Background This study investigated the effects of sodium–glucose cotransporter 2 inhibitors (SGLT2is) on patients with stage 4 cardiovascular–kidney–metabolic syndrome over 1 year. Methods Data from patients with stage 4 cardiovascular–kidney–metabolic syndrome hospitalized at Civil Aviation General...

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Main Authors: Tao Liu, Zeyuan Fan, Yuntao Li, Bing Xiao, Chang He
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.040382
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author Tao Liu
Zeyuan Fan
Yuntao Li
Bing Xiao
Chang He
author_facet Tao Liu
Zeyuan Fan
Yuntao Li
Bing Xiao
Chang He
author_sort Tao Liu
collection DOAJ
description Background This study investigated the effects of sodium–glucose cotransporter 2 inhibitors (SGLT2is) on patients with stage 4 cardiovascular–kidney–metabolic syndrome over 1 year. Methods Data from patients with stage 4 cardiovascular–kidney–metabolic syndrome hospitalized at Civil Aviation General Hospital from March 2021 to September 2023 were collected. Patients were classified into the SGLT2i group and the control group on the basis of SGLT2i exposure. A propensity score–matched model established a well‐balanced comparison between the groups. The initial occurrence of major adverse cardiovascular events (MACEs), major adverse kidney events (MAKEs) and all‐cause death within 1 year were assessed. Results A total of 3657 patients were included, resulting in 812 matched pairs. The SGLT2i group exhibited significant reductions in MACEs, MAKEs, and all‐cause death compared with the control group. Based on adjusted Cox regression, those receiving SGLT2is had a 27.4% lower hazard for MACEs, driven primarily by a 12.4% lower hazard for cardiovascular death and 32.7% lower hazard for heart failure readmission. SGLT2i use reduced the hazard for MAKEs by 11.5%, primarily due to a 19.7% reduction in the hazard for worsen kidney function. All‐cause mortality hazard decreased by 11.3%. Subgroup analyses confirmed consistent cardiovascular and renal benefits of SGLT2is. Further sensitivity analyses supported the robustness of the results. Conclusions SGLT2i use in patients with stage 4 cardiovascular–kidney–metabolic syndrome was associated with reduced hazards of MACEs, MAKEs, and all‐cause death, supporting the cardiovascular and renal benefits in this population.
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spelling doaj-art-53973e54e0d54d84bbff2041e5d884222025-08-20T07:24:54ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-08-01141610.1161/JAHA.124.040382Effects of Sodium–Glucose Cotransporter 2 Inhibitors on Stage 4 Cardiovascular–Kidney–Metabolic Syndrome: A Propensity Score–Matched StudyTao Liu0Zeyuan Fan1Yuntao Li2Bing Xiao3Chang He4Department of Coronary Heart Disease Civil Aviation General Hospital Beijing ChinaDepartment of Coronary Heart Disease Civil Aviation General Hospital Beijing ChinaDepartment of Coronary Heart Disease Civil Aviation General Hospital Beijing ChinaDepartment of Coronary Heart Disease Civil Aviation General Hospital Beijing ChinaDepartment of Coronary Heart Disease Civil Aviation General Hospital Beijing ChinaBackground This study investigated the effects of sodium–glucose cotransporter 2 inhibitors (SGLT2is) on patients with stage 4 cardiovascular–kidney–metabolic syndrome over 1 year. Methods Data from patients with stage 4 cardiovascular–kidney–metabolic syndrome hospitalized at Civil Aviation General Hospital from March 2021 to September 2023 were collected. Patients were classified into the SGLT2i group and the control group on the basis of SGLT2i exposure. A propensity score–matched model established a well‐balanced comparison between the groups. The initial occurrence of major adverse cardiovascular events (MACEs), major adverse kidney events (MAKEs) and all‐cause death within 1 year were assessed. Results A total of 3657 patients were included, resulting in 812 matched pairs. The SGLT2i group exhibited significant reductions in MACEs, MAKEs, and all‐cause death compared with the control group. Based on adjusted Cox regression, those receiving SGLT2is had a 27.4% lower hazard for MACEs, driven primarily by a 12.4% lower hazard for cardiovascular death and 32.7% lower hazard for heart failure readmission. SGLT2i use reduced the hazard for MAKEs by 11.5%, primarily due to a 19.7% reduction in the hazard for worsen kidney function. All‐cause mortality hazard decreased by 11.3%. Subgroup analyses confirmed consistent cardiovascular and renal benefits of SGLT2is. Further sensitivity analyses supported the robustness of the results. Conclusions SGLT2i use in patients with stage 4 cardiovascular–kidney–metabolic syndrome was associated with reduced hazards of MACEs, MAKEs, and all‐cause death, supporting the cardiovascular and renal benefits in this population.https://www.ahajournals.org/doi/10.1161/JAHA.124.040382cardiovascular–kidney–metabolic syndromemajor adverse cardiovascular eventsmajor adverse kidney eventspropensity score–matchedsodium–glucose cotransporter 2 inhibitors
spellingShingle Tao Liu
Zeyuan Fan
Yuntao Li
Bing Xiao
Chang He
Effects of Sodium–Glucose Cotransporter 2 Inhibitors on Stage 4 Cardiovascular–Kidney–Metabolic Syndrome: A Propensity Score–Matched Study
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cardiovascular–kidney–metabolic syndrome
major adverse cardiovascular events
major adverse kidney events
propensity score–matched
sodium–glucose cotransporter 2 inhibitors
title Effects of Sodium–Glucose Cotransporter 2 Inhibitors on Stage 4 Cardiovascular–Kidney–Metabolic Syndrome: A Propensity Score–Matched Study
title_full Effects of Sodium–Glucose Cotransporter 2 Inhibitors on Stage 4 Cardiovascular–Kidney–Metabolic Syndrome: A Propensity Score–Matched Study
title_fullStr Effects of Sodium–Glucose Cotransporter 2 Inhibitors on Stage 4 Cardiovascular–Kidney–Metabolic Syndrome: A Propensity Score–Matched Study
title_full_unstemmed Effects of Sodium–Glucose Cotransporter 2 Inhibitors on Stage 4 Cardiovascular–Kidney–Metabolic Syndrome: A Propensity Score–Matched Study
title_short Effects of Sodium–Glucose Cotransporter 2 Inhibitors on Stage 4 Cardiovascular–Kidney–Metabolic Syndrome: A Propensity Score–Matched Study
title_sort effects of sodium glucose cotransporter 2 inhibitors on stage 4 cardiovascular kidney metabolic syndrome a propensity score matched study
topic cardiovascular–kidney–metabolic syndrome
major adverse cardiovascular events
major adverse kidney events
propensity score–matched
sodium–glucose cotransporter 2 inhibitors
url https://www.ahajournals.org/doi/10.1161/JAHA.124.040382
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