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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
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa54750
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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) 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.
Keywords: Albuminuria; glomerular filtration rate; liraglutide; cardiovascular outcomes; mortality; renal outcomes
College: Faculty of Medicine, Health and Life Sciences
Funders: This work was supported by Novo Nordisk.
Issue: 11
Start Page: 2077
End Page: 2088

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