Cardiorenal Biomarkers, Canagliflozin, and Outcomes in Diabetic Kidney Disease: The CREDENCE Trial
Authors' conclusion
Multiple cardiorenal stress biomarkers are strongly prognostic in people with type 2 diabetes and albuminuria. Canagliflozin modestly reduced the longitudinal trajectory of rise in each biomarker. Change in the biomarker level in addition to the baseline level augments the primary outcome prediction.
Study context
- Population
- People with T2DM and albuminuria (diabetic kidney disease)
- Participants
- 2,627 people
- Comparison
- Canagliflozin vs placebo; prognostic value of cardiorenal biomarkers
Methodological detailsbiomarker analysis
- Biomarker analysis
Primary result
As reported in the abstract
Primary outcome by multimarker panel risk score (vs low risk score)
Hazard ratio (95% CI)
High risk scorevs Low risk score
4.01(2.52–6.35)
Moderate risk scorevs Low risk score
2.39(1.48–3.87)
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Primary outcome per 50% increase in biomarker by 1 yearNT-proBNP 50% increase | 1.11 (1.08–1.15) | |
| Primary outcome per 50% increase in biomarker by 1 yearHigh-sensitivity cardiac troponin T 50% increase | 1.86 (1.64–2.10) | |
| Primary outcome per 50% increase in biomarker by 1 yearGrowth differentiation factor-15 50% increase | 1.45 (1.24–1.70) | |
| Primary outcome per 50% increase in biomarker by 1 yearIGFBP7 50% increase | 3.76 (2.54–5.56) | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Canagliflozin | Placebo |
|---|---|---|
| Rise in biomarker concentrations · 1 yearMultivariable linear mixed-effect models | 3% to 10% | 6% to 29% |
- Rise in biomarker concentrations — Canagliflozin vs placebo, all biomarkers
- all P<0.01
Baseline biomarker concentrations (median, quartiles 1 and 3)
- NT-proBNP
- 180 ng/L (82, 442 ng/L)
- High-sensitivity cardiac troponin T
- 19 ng/L (12, 29 ng/L)
- Growth differentiation factor-15
- 2595 ng/L (1852, 3775 ng/L)
- IGFBP7
- 121.8 ng/mL (105.4, 141.5 ng/mL)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Cardiorenal Biomarkers, Canagliflozin, and Outcomes in Diabetic Kidney Disease: The CREDENCE Trial. Circulation. Published 21 August 2023. doi:10.
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