Effects of canagliflozin on major adverse cardiovascular events (MACE) by baseline estimated glomerular filtration rate: pooled Hispanic subgroup analyses from the CANVAS Program and CREDENCE trial.

Abstract

AIMS\nPeople with type 2 diabetes mellitus (T2DM) have a greater risk of cardiovascular disease and major adverse cardiovascular events (MACE), which become more common as kidney function declines. Canagliflozin reduced the risk of MACE (cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke) in patients with T2DM and high cardiovascular risk or nephropathy in the CANVAS Program and CREDENCE trial. Risk of MACE by kidney status had not been examined in Hispanic participants.\n\n\nMATERIALS AND METHODS\nThis post hoc analysis included integrated, pooled data from the CANVAS Program and CREDENCE. The effects of canagliflozin versus placebo on MACE were assessed in subgroups by baseline eGFR (<45, 45-60, and >60mL/min/1.73 m2 ) overall and in the Hispanic cohort. Hazard ratios (HRs) and 95% CIs were estimated using Cox regression models, with subgroup by treatment interaction terms added to test for heterogeneity.\n\n\nRESULTS\nA total of 14,543 participants were included; 3029 (20.8%) self-identified as Hispanic. In the overall population, canagliflozin reduced the risk of MACE compared with placebo (HR, 0.83; 95%CI, 0.75, 0.92), with no heterogeneity observed across eGFR subgroups (interaction P=0.22). In the Hispanic cohort, canagliflozin also reduced the risk of MACE (HR, 0.71; 95%CI, 0.55, 0.92) with no heterogeneity by baseline eGFR (interaction P=0.25), including among the highest-risk Hispanic participants with baseline eGFR <45mL/min/1.73 m2 .\n\n\nCONCLUSION\nCanagliflozin reduced the risk of MACE overall and among Hispanic participants with T2DM and high cardiovascular risk or nephropathy in the CANVAS Program and CREDENCE, without heterogeneity by baseline eGFR. This article is protected by copyright. All rights reserved.