{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:08:56Z","timestamp":1790726936145,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The fibrosis\u20104 (FIB\u20104) score is used to identify risk of advanced liver fibrosis. This post hoc analysis investigated its prognostic value for cardiovascular (CV) outcomes and its relevance to the effects of dapagliflozin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>DECLARE\u2010TIMI 58 was a randomised, placebo\u2010controlled phase 3 trial investigating dapagliflozin in patients with type 2 diabetes (T2D) and either atherosclerotic cardiovascular disease (ASCVD) or high ASCVD risk. Participants were stratified by baseline FIB\u20104 scores (&lt;\u20091.30, 1.30 to &lt;\u20092.67, and \u2265\u20092.67). Hazard ratios (HRs) and 95% confidence intervals (CIs) for dapagliflozin versus placebo were calculated for the two primary outcomes (major adverse cardiovascular events [MACE] and the composite of CV death and hospitalisation for heart failure [HHF]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 17\u2009160 patients enrolled, 16\u2009361 were included (median follow\u2010up of 4.2\u2009years). Distribution across FIB\u20104 categories was: &lt;\u20091.30,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099084 (55.5%); 1.30 to &lt;\u20092.67,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096556 (40.7%); and \u2265\u20092.67,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009621 (3.8%), with similar ASCVD prevalence across groups (40%\u201343%). In the placebo arm, the \u2265\u20092.67 FIB\u20104 group had the highest event rates for MACE, HHF, CV death, and all\u2010cause death. MACE HRs (95% CIs) for dapagliflozin versus placebo were 0.95 (0.83\u20131.10), 0.92 (0.79\u20131.08), and 0.61 (0.38\u20130.97) across ascending FIB\u20104 groups. For the CV death and HHF composite endpoint, they were 0.81 (0.67\u20130.98), 0.90 (0.73\u20131.10), and 0.50 (0.28\u20130.90). Dapagliflozin reduced aspartate aminotransferase and alanine aminotransferase levels compared with placebo.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Highest FIB\u20104 scores were associated with increased CV risk in patients with T2D. Dapagliflozin reduced CV risk across FIB\u20104 categories without significant interactions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70820","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T06:13:22Z","timestamp":1777356802000},"page":"6142-6150","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Dapagliflozin on Cardiovascular Outcomes in Patients With Type 2 Diabetes at Risk of Liver Fibrosis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4573-517X","authenticated-orcid":false,"given":"Jan","family":"Oscarsson","sequence":"first","affiliation":[{"name":"Late\u2010Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&amp;D AstraZeneca  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Huhn","sequence":"additional","affiliation":[{"name":"Late\u2010Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&amp;D AstraZeneca  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyun","family":"Jiang","sequence":"additional","affiliation":[{"name":"Late\u2010stage Development, Cardiovascular, Renal, and Metabolism BioPharmaceuticals R&amp;D, AstraZeneca  Gaithersburg Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Gause\u2010Nilsson","sequence":"additional","affiliation":[{"name":"Late\u2010Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&amp;D AstraZeneca  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen D.","family":"Wiviott","sequence":"additional","affiliation":[{"name":"Late\u2010Stage Development,\u00a0Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&amp;D AstraZeneca  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8017-1675","authenticated-orcid":false,"given":"Filipe A.","family":"Moura","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine Yale School of Medicine  New Haven Connecticut USA"},{"name":"Veterans Affairs Connecticut Healthcare System  West Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2839-8404","authenticated-orcid":false,"given":"John P. H.","family":"Wilding","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9494-6571","authenticated-orcid":false,"given":"Simona","family":"Cernea","sequence":"additional","affiliation":[{"name":"Department M3\/Internal Medicine I George Emil Palade University of Medicine, Pharmacy, Science, and Technology of T\u00e2rgu Mure\u015f  T\u00e2rgu Mure\u015f Romania"},{"name":"Diabetes, Nutrition and Metabolic Diseases Outpatient Unit Emergency County Clinical Hospital  T\u00e2rgu Mure\u015f Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Van Gaal","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism Antwerp University Hospital  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7830-9994","authenticated-orcid":false,"given":"Avivit","family":"Cahn","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A Hadassah Hebrew University Hospital  Jerusalem Israel"},{"name":"The Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-6245","authenticated-orcid":false,"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Mount Sinai Fuster Heart Hospital Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"Johansson","sequence":"additional","affiliation":[{"name":"Late\u2010Stage Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&amp;D AstraZeneca  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8380-9766","authenticated-orcid":false,"given":"C. 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