New-onset syncope in diabetic patients treated with sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors: a Chinese population-based cohort study
Main finding · New-onset syncopeResult — go to the resultHazard ratio 0.49 95% CI 0.41–0.57Authors' conclusion
Compared with DPP4i, SGLT2i was associated with a significantly lower risk of new-onset syncope in patients with T2DM, regardless of gender, age, degree of glycaemic control, and comorbidity burden.
Study context
- Population
- T2DM patients treated with SGLT2i or DPP4i, Hong Kong, China, 2015–2020matched cohort
- Participants
- 37,502 patients
- Exposure
- SGLT2i vs DPP4i
- SGLT2in = 18,751
- DPP4in = 18,751reference
- Outcome
- Hospitalization for new-onset syncope
- Follow-up
- Median 5.56 years
Methodological detailsterritory-wide, propensity-score matched
- Territory-wide
- Propensity-score matched
Main finding
New-onset syncope
Hazard ratio
0.49
95% CI 0.41–0.57
P < 0.001
SGLT2i vs DPP4i
HR 0.49 (95% CI 0.41–0.57); P < 0.001
As reported in the abstract
- Hospitalized for new-onset syncope (overall)
- 907 (2.41%)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| CV mortalityFully adjusted model | 0.35 (0.26–0.46) | P < 0.001 | |
| All-cause mortalityFully adjusted model | 0.30 (0.26–0.34) | P < 0.001 | |
| New-onset syncope, by individual SGLT2iDapagliflozin vs DPP4i | 0.70 (0.58–0.85) | P < 0.001 | |
| New-onset syncope, by individual SGLT2iCanagliflozin vs DPP4i | 0.48 (0.36–0.63) | P < 0.001 | |
| New-onset syncope, by individual SGLT2iErtugliflozin vs DPP4i | 0.45 (0.30–0.68) | P < 0.001 | |
| New-onset syncope, by individual SGLT2iEmpagliflozin vs DPP4i · attenuated | 0.79 (0.59–1.05) | P = 0.100 | |
| 0.20.5125Hazard ratio (log scale) |
- CV mortality — CV deaths (overall)
- 471 (1.26%)
- All-cause mortality — Deaths from any cause (overall)
- 2346 (6.26%)
New-onset syncope, subgroups
- Significantly lower risk with SGLT2i regardless of gender, age, glucose control, Charlson comorbidity index; constant with common CV drugs and most antidiabetic drugs at baseline
Original publication
New-onset syncope in diabetic patients treated with sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors: a Chinese population-based cohort study. Eur Heart J Cardiovasc Pharmacother. Published 14 November 2023. doi:10.
Summarised from the published abstract; every number is checked against it