Associations of SGLT2i with Cardiorenal Outcomes Among Diabetics with Prostate Cancer on Hormone Therapy.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Drugs and Therapy Pub Date : 2024-11-11 DOI:10.1007/s10557-024-07646-1

Efstratios Koutroumpakis, Rushin Patel, Sumanth Khadke, Aram Bedrosian, Ashish Kumar, Yixin Kong, Brendan Connell, Jagriti Upadhyay, Sourbha S Dani, Andrew W Hahn, Christopher J Logothetis, Sadeer Al-Kindi, Javed Butler, Anju Nohria, Sarju Ganatra, Anita Deswal

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Abstract

Purpose: Studies have reported associations between prostate cancer, type II diabetes mellitus (T2DM), and cardiovascular disease in the context of treatment with hormone therapy (HT). This study aimed to assess the role of Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) in preventing adverse cardiovascular and renal outcomes in diabetics with prostate cancer.

Methods: Patients ≥ 18 years of age with T2DM and prostate cancer who received HT between August 1, 2013, and August 31, 2021, were identified using the TriNetX research network. Patients were divided into two cohorts based on treatment with SGLT2i or alternative antidiabetic therapies. The primary outcome was the composite of all-cause mortality, new-onset heart failure (HF), acute myocardial infarction (MI), and peripheral artery disease over 2 years from HT initiation.

Results: After propensity score matching, 2155 patients remained in each cohort. The primary composite outcome occurred in 218 patients (16.1%) in the SGLT2i cohort versus 355 patients (26.3%) in the non-SGLT2i cohort (OR 0.539, 95% CI 0.446-0.651; p < 0.001). Furthermore, SGLT2i were associated with significantly lower odds of HF, HF exacerbation, peripheral artery disease, atrial fibrillation/flutter, cardiac arrest, need for renal replacement therapy, overall emergency room visits/hospitalizations, and all-cause mortality.

Conclusions: Use of SGLT2i for the treatment of T2DM among patients with prostate cancer on HT is associated with favorable cardiovascular, renal, and all-cause mortality outcomes. This observation supports the hypothesis that a therapeutically relevant link exists between HT and cardiovascular disease in the context of prostate cancer.

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接受激素治疗的前列腺癌糖尿病患者中 SGLT2i 与心肾结果的关系

目的：有研究报告称，在激素治疗（HT）的背景下，前列腺癌、II型糖尿病（T2DM）和心血管疾病之间存在关联。本研究旨在评估钠-葡萄糖转运体-2抑制剂（SGLT2i）在预防前列腺癌糖尿病患者心血管和肾脏不良预后方面的作用：通过 TriNetX 研究网络确定 2013 年 8 月 1 日至 2021 年 8 月 31 日期间接受 HT 治疗的年龄≥ 18 岁的 T2DM 和前列腺癌患者。根据SGLT2i或其他抗糖尿病疗法的治疗情况，患者被分为两个队列。主要结果是自开始使用 HT 起 2 年内全因死亡率、新发心力衰竭 (HF)、急性心肌梗死 (MI) 和外周动脉疾病的复合结果：经过倾向评分匹配后，每个队列中仍有 2155 名患者。SGLT2i队列中有218名患者（16.1%）出现了主要综合结果，而非SGLT2i队列中有355名患者（26.3%）出现了主要综合结果（OR为0.539，95% CI为0.446-0.651；P 结论：SGLT2i是一种有效的降压药：使用 SGLT2i 治疗接受 HT 治疗的前列腺癌患者中的 T2DM 与有利的心血管、肾脏和全因死亡率结果相关。这一观察结果支持了这样的假设：在前列腺癌的情况下，高血压与心血管疾病之间存在治疗相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Drugs and Therapy 医学-心血管系统

CiteScore

8.30

自引率

0.00%

发文量

110

审稿时长

4.5 months

期刊介绍： Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field. Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients. Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.