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Cardiovascular and renal outcomes by baseline albuminuria status and renal function: Results from the LEADER randomized trial
Diabetes, Obesity and Metabolism, Volume: 22, Issue: 11, Pages: 2077 - 2088
Swansea University Author: Steve Bain
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DOI (Published version): 10.1111/dom.14126
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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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.
Albuminuria; glomerular filtration rate; liraglutide; cardiovascular outcomes; mortality; renal outcomes
Faculty of Medicine, Health and Life Sciences
This work was supported by Novo Nordisk.