Gender disparities in time-to-initiation of cardioprotective glucose-lowering drugs in patients with type 2 diabetes and cardiovascular disease: a Danish nationwide cohort study

Cardiovascular Diabetology

Research

Erik Lerkevang Grove¹  Anders Aasted Isaksen²  Kristian Løkke Funck³  Lasse Bjerg⁴  Annelli Sandbæk⁴ 

[1] Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark;Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark;Department of Public Health, Aarhus University, Aarhus, Denmark;Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark;Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark;Department of Public Health, Aarhus University, Aarhus, Denmark;

关键词: Type 2 diabetes;    Cardiovascular disease;    Antidiabetic agents;    Pharmacoepidemiology;    Gender equity;    Sex;   

DOI  :  10.1186/s12933-022-01713-3

 received in 2022-10-28, accepted in 2022-12-01,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundWe aimed to examine the impact of gender and specific type of cardiovascular disease (CVD) diagnosis (ischemic heart disease [IHD], heart failure, peripheral artery disease [PAD] or stroke) on time-to-initiation of either a sodium glucose cotransporter 2 inhibitor or glucagon-like peptide 1 analogue (collectively termed cardioprotective GLD) after a dual diagnosis of type 2 diabetes (T2DM) and CVD.MethodsIn a nationwide cohort study, we identified patients with a new dual diagnosis of T2DM and CVD (January 1, 2012 and December 31, 2018). Cumulative user proportion (CUP) were assessed. Poisson models were used to estimate the initiation rate of cardioprotective GLDs. The final analyses were adjusted for potential confounders.ResultsIn total, we included 70,538 patients with new-onset T2DM and CVD (38% female, mean age 70 ± 12 years at inclusion). During 183,256 person-years, 6,276 patients redeemed a prescription of a cardioprotective GLD. One-year CUPs of cardioprotective GLDs were lower in women than men. Initiation rates of GLDs were lower in women (female-to-male initiation-rate-ratio crude: 0.76, 95% CI 0.72–0.81); adjusted 0.92, 95% CI 0.87–0.97). In CVD-stratified analysis, the adjusted initiation rate ratio was lower in female patients with IHD and heart failure (IHD: 0.91 [95% CI 0.85–0.98], heart failure: 0.85 [95% CI 0.73–1.00], PAD: 0.92 [95% CI 0.78–1.09], and stroke: 1.06 [95% CI 0.93–1.20]).ConclusionsAmong patients with a new dual diagnosis of T2DM and CVD, female gender is associated with lower initiation rates of cardioprotective GLDs, especially if the patient has IHD or heart failure.

【 授权许可】

CC BY   
© The Author(s) 2022

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