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Effects of dapaglif...
Effects of dapagliflozin on mortality in patients with chronic kidney disease : a pre-specified analysis from the DAPA-CKD randomized controlled trial.
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Heerspink, Hiddo J L (author)
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Sjöström, C David (author)
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Jongs, Niels (author)
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Chertow, Glenn M (author)
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Kosiborod, Mikhail (author)
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Hou, Fan Fan (author)
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McMurray, John J V (author)
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Rossing, Peter (author)
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Correa-Rotter, Ricardo (author)
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Kurlyandskaya, Raisa (author)
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Stefansson, Bergur V (author)
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Toto, Robert D (author)
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Langkilde, Anna Maria (author)
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Wheeler, David C (author)
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- Held, Claes, 1956- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,kardiologi
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(creator_code:org_t)
- 2021-04-01
- 2021
- English.
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In: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 42:13, s. 1216-1227
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Abstract
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- AIMS: Mortality rates from chronic kidney disease (CKD) have increased in the last decade. In this pre-specified analysis of the DAPA-CKD trial, we determined the effects of dapagliflozin on cardiovascular and non-cardiovascular causes of death.METHODS AND RESULTS: DAPA-CKD was an international, randomized, placebo-controlled trial with a median of 2.4 years of follow-up. Eligible participants were adult patients with CKD, defined as a urinary albumin-to-creatinine ratio (UACR) 200-5000 mg/g and an estimated glomerular filtration rate (eGFR) 25-75 mL/min/1.73 m2. All-cause mortality was a key secondary endpoint. Cardiovascular and non-cardiovascular death was adjudicated by an independent clinical events committee. The DAPA-CKD trial randomized participants to dapagliflozin 10 mg/day (n = 2152) or placebo (n = 2152). The mean age was 62 years, 33% were women, the mean eGFR was 43.1 mL/min/1.73 m2, and the median UACR was 949 mg/g. During follow-up, 247 (5.7%) patients died, of whom 91 (36.8%) died due to cardiovascular causes, 102 (41.3%) due to non-cardiovascular causes, and in 54 (21.9%) patients, the cause of death was undetermined. The relative risk reduction for all-cause mortality with dapagliflozin (31%, hazard ratio [HR] [95% confidence interval (CI)] 0.69 [0.53, 0.88]; P = 0.003) was consistent across pre-specified subgroups. The effect on all-cause mortality was driven largely by a 46% relative risk reduction of non-cardiovascular death (HR [95% CI] 0.54 [0.36, 0.82]). Deaths due to infections and malignancies were the most frequently occurring causes of non-cardiovascular deaths and were reduced with dapagliflozin vs. placebo.CONCLUSION: In patients with CKD, dapagliflozin prolonged survival irrespective of baseline patient characteristics. The benefits were driven largely by reductions in non-cardiovascular death.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Chronic kidney disease
- Dapagliflozin
- SGLT2 inhibitor
Publication and Content Type
- ref (subject category)
- art (subject category)
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Heerspink, Hiddo ...
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Sjöström, C Davi ...
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Jongs, Niels
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Chertow, Glenn M
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Kosiborod, Mikha ...
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Hou, Fan Fan
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show more...
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McMurray, John J ...
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Rossing, Peter
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Correa-Rotter, R ...
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Kurlyandskaya, R ...
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Stefansson, Berg ...
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Toto, Robert D
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Langkilde, Anna ...
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Wheeler, David C
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Held, Claes, 195 ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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European Heart J ...
- By the university
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Uppsala University