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Cardiovascular and renal outcomes by baseline albuminuria status and renal function: Results from the LEADER randomized trial

Ofri Mosenzon Orcid Logo, Steve Bain Orcid Logo, Hiddo J. L. Heerspink Orcid Logo, Thomas Idorn, Johannes F. E. Mann, Frederik Persson Orcid Logo, Richard E. Pratley, Søren Rasmussen, Peter Rossing, Bernt Johan von Scholten, Itamar Raz Orcid Logo, (LEADER Trial Investigators)

Diabetes, Obesity and Metabolism, Volume: 22, Issue: 11, Pages: 2077 - 2088

Swansea University Author: Steve Bain Orcid Logo

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DOI (Published version): 10.1111/dom.14126

Abstract

AimTo assess cardiorenal outcomes by baseline urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) in the contemporary LEADER cohort.Materials and methodsLEADER was a multinational, double-blind trial. Patients with type 2 diabetes and high cardiovascular (CV) r...

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Published in: Diabetes, Obesity and Metabolism
ISSN: 1462-8902 1463-1326
Published: Wiley 2020
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URI: https://cronfa.swan.ac.uk/Record/cronfa54750
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Patients with type 2 diabetes and high cardiovascular (CV) risk were randomized 1:1 to the glucagon-like peptide-1 analogue liraglutide (&#x2264;1.8 mg daily; n = 4668) or placebo (n = 4672) plus standard care and followed for 3.5 to 5&#x2009;years. Primary composite outcomes were time to first non-fatal myocardial infarction, non-fatal stroke or CV death. Post hoc Cox regression analyses of outcomes by baseline UACR and eGFR subgroups were conducted with adjustment for baseline variables.ResultsIn the LEADER population, 1598 (17.5%), 2917 (31.9%), 1200 (13.1%), 1611 (17.6%), 845 (9.2%) and 966 (10.6%) had UACR = 0, &gt;0 to &lt;15, 15 to &lt;30, 30 to &lt;100, 100 to &lt;300 and &#x2265;300&#x2009;mg/g, respectively. Increasing UACR and decreasing eGFR were linked with higher risks of the primary outcome, heart failure hospitalization, a composite renal outcome and death (P-values for the Cochran-Armitage test for trends were all &lt;.0001). Across UACR and eGFR subgroups, risks of cardiorenal events and death were generally lower or similar with liraglutide versus placebo.ConclusionsIn a contemporary type 2 diabetes population, increasing baseline UACR and declining eGFR were linked with higher risks of cardiorenal events and death.</abstract><type>Journal Article</type><journal>Diabetes, Obesity and Metabolism</journal><volume>22</volume><journalNumber>11</journalNumber><paginationStart>2077</paginationStart><paginationEnd>2088</paginationEnd><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1462-8902</issnPrint><issnElectronic>1463-1326</issnElectronic><keywords>Albuminuria; glomerular filtration rate; liraglutide; cardiovascular outcomes; mortality; renal outcomes</keywords><publishedDay>1</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2020</publishedYear><publishedDate>2020-11-01</publishedDate><doi>10.1111/dom.14126</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This work was supported by Novo Nordisk.</funders><projectreference/><lastEdited>2022-12-02T19:16:51.8929353</lastEdited><Created>2020-07-15T11:53:57.1945412</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Ofri</firstname><surname>Mosenzon</surname><orcid>0000-0002-5702-7584</orcid><order>1</order></author><author><firstname>Steve</firstname><surname>Bain</surname><orcid>0000-0001-8519-4964</orcid><order>2</order></author><author><firstname>Hiddo J. 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spelling 2022-12-02T19:16:51.8929353 v2 54750 2020-07-15 Cardiovascular and renal outcomes by baseline albuminuria status and renal function: Results from the LEADER randomized trial 5399f4c6e6a70f3608a084ddb938511a 0000-0001-8519-4964 Steve Bain Steve Bain true false 2020-07-15 MEDS AimTo assess cardiorenal outcomes by baseline urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) in the contemporary LEADER cohort.Materials and methodsLEADER was a multinational, double-blind trial. Patients with type 2 diabetes and high cardiovascular (CV) risk were randomized 1:1 to the glucagon-like peptide-1 analogue liraglutide (≤1.8 mg daily; n = 4668) or placebo (n = 4672) plus standard care and followed for 3.5 to 5 years. Primary composite outcomes were time to first non-fatal myocardial infarction, non-fatal stroke or CV death. Post hoc Cox regression analyses of outcomes by baseline UACR and eGFR subgroups were conducted with adjustment for baseline variables.ResultsIn the LEADER population, 1598 (17.5%), 2917 (31.9%), 1200 (13.1%), 1611 (17.6%), 845 (9.2%) and 966 (10.6%) had UACR = 0, >0 to <15, 15 to <30, 30 to <100, 100 to <300 and ≥300 mg/g, respectively. Increasing UACR and decreasing eGFR were linked with higher risks of the primary outcome, heart failure hospitalization, a composite renal outcome and death (P-values for the Cochran-Armitage test for trends were all <.0001). Across UACR and eGFR subgroups, risks of cardiorenal events and death were generally lower or similar with liraglutide versus placebo.ConclusionsIn a contemporary type 2 diabetes population, increasing baseline UACR and declining eGFR were linked with higher risks of cardiorenal events and death. Journal Article Diabetes, Obesity and Metabolism 22 11 2077 2088 Wiley 1462-8902 1463-1326 Albuminuria; glomerular filtration rate; liraglutide; cardiovascular outcomes; mortality; renal outcomes 1 11 2020 2020-11-01 10.1111/dom.14126 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University This work was supported by Novo Nordisk. 2022-12-02T19:16:51.8929353 2020-07-15T11:53:57.1945412 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Ofri Mosenzon 0000-0002-5702-7584 1 Steve Bain 0000-0001-8519-4964 2 Hiddo J. L. Heerspink 0000-0002-3126-3730 3 Thomas Idorn 4 Johannes F. E. Mann 5 Frederik Persson 0000-0001-6242-6638 6 Richard E. Pratley 7 Søren Rasmussen 8 Peter Rossing 9 Bernt Johan von Scholten 10 Itamar Raz 0000-0003-0209-4453 11 (LEADER Trial Investigators) 12 54750__18497__d7232bc0b3014ad690e531fc3cb149f2.pdf 54750.pdf 2020-10-26T15:41:32.5964555 Output 1189189 application/pdf Version of Record true This is an open access article under the terms of the Creative Commons Attribution-Non Commercial License true eng https://creativecommons.org/licenses/by-nc/4.0/
title Cardiovascular and renal outcomes by baseline albuminuria status and renal function: Results from the LEADER randomized trial
spellingShingle Cardiovascular and renal outcomes by baseline albuminuria status and renal function: Results from the LEADER randomized trial
Steve Bain
title_short Cardiovascular and renal outcomes by baseline albuminuria status and renal function: Results from the LEADER randomized trial
title_full Cardiovascular and renal outcomes by baseline albuminuria status and renal function: Results from the LEADER randomized trial
title_fullStr Cardiovascular and renal outcomes by baseline albuminuria status and renal function: Results from the LEADER randomized trial
title_full_unstemmed Cardiovascular and renal outcomes by baseline albuminuria status and renal function: Results from the LEADER randomized trial
title_sort Cardiovascular and renal outcomes by baseline albuminuria status and renal function: Results from the LEADER randomized trial
author_id_str_mv 5399f4c6e6a70f3608a084ddb938511a
author_id_fullname_str_mv 5399f4c6e6a70f3608a084ddb938511a_***_Steve Bain
author Steve Bain
author2 Ofri Mosenzon
Steve Bain
Hiddo J. L. Heerspink
Thomas Idorn
Johannes F. E. Mann
Frederik Persson
Richard E. Pratley
Søren Rasmussen
Peter Rossing
Bernt Johan von Scholten
Itamar Raz
(LEADER Trial Investigators)
format Journal article
container_title Diabetes, Obesity and Metabolism
container_volume 22
container_issue 11
container_start_page 2077
publishDate 2020
institution Swansea University
issn 1462-8902
1463-1326
doi_str_mv 10.1111/dom.14126
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description AimTo assess cardiorenal outcomes by baseline urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) in the contemporary LEADER cohort.Materials and methodsLEADER was a multinational, double-blind trial. Patients with type 2 diabetes and high cardiovascular (CV) risk were randomized 1:1 to the glucagon-like peptide-1 analogue liraglutide (≤1.8 mg daily; n = 4668) or placebo (n = 4672) plus standard care and followed for 3.5 to 5 years. Primary composite outcomes were time to first non-fatal myocardial infarction, non-fatal stroke or CV death. Post hoc Cox regression analyses of outcomes by baseline UACR and eGFR subgroups were conducted with adjustment for baseline variables.ResultsIn the LEADER population, 1598 (17.5%), 2917 (31.9%), 1200 (13.1%), 1611 (17.6%), 845 (9.2%) and 966 (10.6%) had UACR = 0, >0 to <15, 15 to <30, 30 to <100, 100 to <300 and ≥300 mg/g, respectively. Increasing UACR and decreasing eGFR were linked with higher risks of the primary outcome, heart failure hospitalization, a composite renal outcome and death (P-values for the Cochran-Armitage test for trends were all <.0001). Across UACR and eGFR subgroups, risks of cardiorenal events and death were generally lower or similar with liraglutide versus placebo.ConclusionsIn a contemporary type 2 diabetes population, increasing baseline UACR and declining eGFR were linked with higher risks of cardiorenal events and death.
published_date 2020-11-01T19:55:28Z
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score 11.04748

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